The association of change in medication regimen and use of inappropriate medication based on beers criteria with adverse outcomes in Japanese long-term care facilities

2016 ◽  
Vol 17 (4) ◽  
pp. 591-597 ◽  
Author(s):  
Shinya Ishii ◽  
Taro Kojima ◽  
Kazuhiko Ezawa ◽  
Kentaro Higashi ◽  
Yukihiko Ikebata ◽  
...  
Keyword(s):  
Long Term Care ◽  
Inappropriate Medication ◽  
Adverse Outcomes ◽  
Beers Criteria ◽  
Medication Regimen ◽  
Term Care ◽  
Care Facilities

scholarly journals Case–control study to estimate odds of death within 28 days of positive test for SARS-CoV-2 prior to vaccination for residents of long-term care facilities in England, 2020–2021

2021 ◽  
pp. jech-2021-218135
Author(s):  
Karthik Paranthaman ◽  
Hester Allen ◽  
Dimple Chudasama ◽  
Neville Q Verlander ◽  
James Sedgwick
Keyword(s):  
Long Term Care ◽  
Multivariable Analysis ◽  
Adverse Outcomes ◽  
Positive Test ◽  
Mortality Data ◽  
Multivariable Logistic Regression Analysis ◽  
Term Care ◽  
Increased Risk ◽  
Care Facilities

BackgroundPersons living in long-term care facilities (LTCFs) are presumed to be at higher risk of adverse outcomes from SARS-CoV-2 infection due to increasing age and frailty, but the magnitude of increased risk is not well quantified.MethodsAfter linking demographic and mortality data for cases with confirmed SARS-CoV-2 infection between March 2020 and January 2021 in England, a random sample of 6000 persons who died and 36 000 who did not die within 28 days of a positive test was obtained from the dataset of 3 020 800 patients. Based on an address-matching process, the residence type of each case was categorised into one of private home and residential or nursing LTCF. Univariable and multivariable logistic regression analysis was conducted.ResultsMultivariable analysis showed that an interaction effect between age and residence type determined the outcome. Compared with a 60-year-old person not living in LTCF, the adjusted OR (aOR) for same-aged persons living in residential and nursing LTCFs was 1.77 (95% CI 1.21 to 2.6, p=0.0017) and 3.95 (95% CI 2.77 to 5.64, p<0.0001), respectively. At 90 years of age, aORs were 0.87 (95% CI 0.72 to 1.06, p=0.21) and 0.74 (95% CI 0.61 to 0.9, p=0.001), respectively. The model had an overall accuracy of 94.2% (94.2%) when applied to the full dataset of 2 978 800 patients.ConclusionThis study found that residents of LTCFs in England had higher odds of death up to 80 years of age. Beyond 80 years, there was no difference in the odds of death for LTCF residents compared with those in the wider community.

scholarly journals Monitoring polypharmacy in healthcare systems through a multi-setting survey: should we put more attention on long term care facilities?

2016 ◽  
Vol 5 (3) ◽  
Author(s):  
Luca Arnoldo ◽  
Giovanni Cattani ◽  
Piergiorgio Cojutti ◽  
Federico Pea ◽  
Silvio Brusaferro
Keyword(s):  
Long Term Care ◽  
Beers Criteria ◽  
Regional Health ◽  
Term Care ◽  
Point Prevalence Study ◽  
Healthcare Settings ◽  
Care Facilities ◽  
Acute Hospitals ◽  
Design And Methods

<em>Background</em>. Polypharmacy is a main issue of patient safety in all healthcare settings (<em>i.e.</em> increase adverse drug reactions and incidence of drug-drug interactions, etc.). The main object of the study was to evaluate the prevalence of polypharmacy and the appropriateness of drugs prescriptions in the regional health system (RHS) of Friuli Venezia-Giulia Region, Italy. <br /><em>Design and methods</em>. We carried out a point prevalence study in May 2014; 1582 patients ≥65 years were included from: 14 acute hospitals, 46 Long Term Care Facilities (LTCFs) and 42 general practitioners’ (GPs) clinics. Data analysis included the evaluation of potentially inappropriate prescriptions (PIPs) taking Beers criteria as a reference. <br /><em>Results</em>. Patients in therapy with 10 drugs or more were 13.5%: 15.2% in hospitals, 9.7% in GPs’ clinics and 15.6% in LTCFs. According to Beers criteria we identified 1152 PIPs that involved globally almost half of patients (46.0%): 41.9% in hospitals, 59.6% in LTCFs and 37.0% in GP’s clinics. The 53.9% of patients received at least one mainly kidney excreted drug; for these patients the evaluation of serum creatinine was overall present in the 87.7% (747/852): 96.4% in hospital ones, 87.5% in GPs’ clinics and 77.8% in LTCFs. LTCFs residents were significantly (P&lt;0.05) more exposed to PIPs and less monitored for the renal function. <br /><em>Conclusions</em>. A reliable estimation of the phenomenon in all the main healthcare settings is a necessary prerequisite to set tailored policies for facing polypharmacy within a RHS; the results showed the necessity to put a special attention on LTCFs.

Factors associated with medication regimen complexity in residents of long-term care facilities

2015 ◽  
Vol 6 (6) ◽  
pp. 561-564 ◽  
Author(s):  
M. Herson ◽  
J.S. Bell ◽  
E.C.K. Tan ◽  
T. Emery ◽  
L. Robson ◽  
...  
Keyword(s):  
Long Term Care ◽  
Medication Regimen ◽  
Term Care ◽  
Factors Associated ◽  
Medication Regimen Complexity ◽  
Regimen Complexity ◽  
Care Facilities

scholarly journals Potentially inappropriate medication among people with dementia in eight European countries

2017 ◽  
Vol 47 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Anna Renom-Guiteras ◽  
Petra A Thürmann ◽  
Ramón Miralles ◽  
Renate Klaaßen-Mielke ◽  
Ulrich Thiem ◽  
...  
Keyword(s):  
Long Term Care ◽  
Inappropriate Medication ◽  
Cognitive Status ◽  
Adverse Outcomes ◽  
Potentially Inappropriate Medication ◽  
The European Union ◽  
Term Care ◽  
People With Dementia

Abstract Objectives to evaluate the frequency of potentially inappropriate medication (PIM) prescription among older people with dementia (PwD) from eight countries participating in the European study ‘RightTimePlaceCare’, and to evaluate factors and adverse outcomes associated with PIM prescription. Methods survey of 2,004 PwD including a baseline assessment and follow-up after 3 months. Interviewers gathered data on age, sex, prescription of medication, cognitive status, functional status, comorbidity, setting and admission to hospital, fall-related injuries and mortality in the time between baseline and follow-up. The European Union(7)-PIM list was used to evaluate PIM prescription. Multivariate regression analysis was used to investigate factors and adverse outcomes associated with PIM prescription. Results overall, 60% of the participants had at least one PIM prescription and 26.4% at least two. The PIM therapeutic subgroups most frequently prescribed were psycholeptics (26% of all PIM prescriptions) and ‘drugs for acid-related disorders’ (21%). PwD who were 80 years and older, lived in institutional long-term care settings, had higher comorbidity and were more functionally impaired were at higher risk of being prescribed two PIM or more. The prescription of two or more PIM was associated with higher chance of suffering from at least one fall-related injury and at least one episode of hospitalisation in the time between baseline and follow-up. Conclusions PIM use among PwD is frequent and is associated with institutional long-term care, age, advanced morbidity and functional impairment. It also appears to be associated with adverse outcomes. Special attention should be paid to psycholeptics and drugs for acid-related disorders.

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