Institute of General Medicine, Family Medicine and Preventive Medicine, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.
Wien Klin Wochenschr. 2013 Apr;125(7-8):180-8. doi: 10.1007/s00508-013-0342-2. Epub 2013 Mar 28.
Potentially inappropriate prescriptions (PIP) are an important cause of adverse medication-related events and increases morbidity, hospitalization, and health care costs, especially in nursing home residents. However, little is known about the associations between PIP and residents' characteristics.
The aim of our study was to analyse the prevalence and associations of PIP with residents' and facilities' characteristics.
We performed a secondary analysis of a cross-sectional study with 48 out of 50 eligible nursing homes and 1,844 out of 2,005 eligible residents in a defined rural-urban area in Austria. The Austrian list of potentially inappropriate medications was applied for the evaluation of inappropriate prescribing. Cluster-adjusted multiple regression analysis was used to investigate institutional and residents' characteristics associated with PIP.
Mean cluster-adjusted prevalence of residents with at least one PIP was 70.3 % (95 % CI 67.2-73.4). The number of residents with at least one psychotropic PIP was 1.014 (55 %). The most often prescribed PIP were Prothipendyl (25.9 % residents), Lorazepam (14.5 %) and Diclofenac (6.1 %). Multiple regression analysis showed an inverse association of PIP with cognitive impairment and significant positive associations with permanent restlessness and permanent negative attitude. The associations of PIP with age and male gender were inconsistent. No significant associations were found for PIP and the ratio of staff nurses to residents.
Our study results confirm that PIP is highly prevalent in the nursing home population. These results urgently call for effective interventions. Initiatives and successful interventions performed in other countries could serve as examples for safer prescribing in residents in Austria.
潜在不适当处方（PIP）是药物相关不良事件的重要原因，会增加发病率、住院率和医疗保健成本，尤其是在养老院居民中。然而，人们对 PIP 与居民特征之间的关系知之甚少。
我们的研究目的是分析 PIP 与居民和设施特征的相关性。
我们对奥地利一个定义明确的城乡地区的 48 家符合条件的养老院和 2005 名符合条件的居民中的 1844 名居民进行了一项横断面研究的二次分析。应用奥地利潜在不适当药物清单评估不适当处方。采用聚类调整多元回归分析来研究与 PIP 相关的机构和居民特征。
调整聚类后，至少有一种 PIP 的居民的平均流行率为 70.3%（95%CI 67.2-73.4）。至少有一种精神药物 PIP 的居民人数为 1014 人（55%）。最常开的 PIP 是丙戊嗪（25.9%的居民）、劳拉西泮（14.5%）和双氯芬酸（6.1%）。多元回归分析显示，PIP 与认知障碍呈负相关，与持续躁动和持续消极态度呈显著正相关。PIP 与年龄和男性性别之间的关联不一致。PIP 与护士与居民的比例之间没有显著关联。
我们的研究结果证实，PIP 在养老院人群中高度流行。这些结果迫切需要有效的干预措施。其他国家开展的举措和成功的干预措施可以为奥地利居民更安全的处方提供范例。
