Department of Nursing Sciences, University of Antwerp, Antwerp, Belgium.
Pharmacoepidemiol Drug Saf. 2010 Oct;19(10):1041-8. doi: 10.1002/pds.1983.
This study aims to investigate drug utilization in Belgian nursing homes in relation to the characteristics of residents and the institution.
A cross-sectional study design was used. A total of 2510 residents were randomly selected from a stratified random sample of 76 Belgian nursing homes with at least 30 beds, including high-intensity care beds. Data collection was based on medical chart review supplemented with clinical information from general practitioners (GPs)
The residents included had a mean age of 85 and 77% were female. They presented a median of 2 clinical problems (range 0-10), three care problems (range 0-10) and 48% had dementia. Their medical consumption amounted to a mean of 8.4 prescriptions including 7.1 for chronic treatment. Mean expenditure per month for chronic medication was 140 EUR (SD 125), including 53 EUR out-of-pocket payment.This study confirmed that multiple comorbidity was associated with polypharmacy. After peaking in the seventh decade, medical consumption decreased in older age groups. In palliative care, the number of prescriptions decreased while expenditure increased. A marked decrease in prescriptions, particularly of pain-relieving medication, was observed with increasing dementia. Larger public institutions, with an active coordinating physician and served by hospital pharmacists, had lower consumption and expenditure.
A high level of drug utilization, influenced by the characteristics of residents and the institution, was observed in Belgian nursing homes. There is a need to develop a comprehensive monitoring system of prescribing quality for nursing home residents.
本研究旨在调查比利时养老院的药物使用情况，以及与居民和机构特征的关系。
采用横断面研究设计。从至少有 30 张床位的 76 家比利时养老院中，随机抽取了 2510 名居民作为分层随机样本，其中包括高护理强度床位。数据收集基于病历审查，并辅以全科医生（GP）提供的临床信息。
被纳入的居民平均年龄为 85 岁，77%为女性。他们的中位数有 2 个临床问题（范围 0-10），3 个护理问题（范围 0-10），48%患有痴呆症。他们的医疗消费平均为 8.4 张处方，其中 7.1 张用于慢性治疗。每月用于慢性药物治疗的平均支出为 140 欧元（SD 125），其中自付费用为 53 欧元。本研究证实，多种合并症与多种药物治疗相关。在 70 多岁时达到峰值后，老年人群的医疗消费呈下降趋势。在姑息治疗中，处方数量减少，而支出增加。随着痴呆症的加重，处方数量，特别是止痛药物的处方数量明显减少。较大的公立机构，有积极的协调医生，并由医院药剂师提供服务，其消费和支出较低。
在比利时养老院中观察到药物使用水平较高，受到居民和机构特征的影响。有必要为养老院居民开发一个全面的处方质量监测系统。
