Department of Gerontology, Neuroscience and Orthopedics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy.
Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Aging Clin Exp Res. 2018 Sep;30(9):1015-1021. doi: 10.1007/s40520-018-0893-1. Epub 2018 Jan 16.
Drugs may interact with geriatric syndromes by playing a role in the continuation, recurrence or worsening of these conditions. Aim of this study is to assess the prevalence of interactions between drugs and three common geriatric syndromes (delirium, falls and urinary incontinence) among older adults in nursing home and home care in Europe.
We performed a cross-sectional multicenter study among 4023 nursing home residents participating in the Services and Health for Elderly in Long-TERm care (Shelter) project and 1469 home care patients participating in the Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (IBenC) project. Exposure to interactions between drugs and geriatric syndromes was assessed by 2015 Beers criteria.
790/4023 (19.6%) residents in the Shelter Project and 179/1469 (12.2%) home care patients in the IBenC Project presented with one or more drug interactions with geriatric syndromes. In the Shelter project, 288/373 (77.2%) residents experiencing a fall, 429/659 (65.1%) presenting with delirium and 180/2765 (6.5%) with urinary incontinence were on one or more interacting drugs. In the IBenC project, 78/172 (45.3%) participants experiencing a fall, 80/182 (44.0%) presenting with delirium and 36/504 (7.1%) with urinary incontinence were on one or more interacting drugs.
Drug-geriatric syndromes interactions are common in long-term care patients. Future studies and interventions aimed at improving pharmacological prescription in the long-term care setting should assess not only drug-drug and drug-disease interactions, but also interactions involving geriatric syndromes.
药物可能通过在这些病症的持续、复发或恶化中发挥作用，与老年综合征相互作用。本研究旨在评估药物与三种常见老年综合征（谵妄、跌倒和尿失禁）之间的相互作用在疗养院和家庭护理中的老年患者中的流行情况。
我们对参加长期护理服务和健康老年人项目（Shelter）的 4023 名疗养院居民和参加确定依赖护理老年人最佳实践的基准社区护理成本和结果项目（IBenC）的 1469 名家庭护理患者进行了一项横断面多中心研究。通过 2015 年 Beers 标准评估药物与老年综合征相互作用的暴露情况。
Shelter 项目中有 790/4023（19.6%）名居民和 IBenC 项目中有 179/1469（12.2%）名家庭护理患者存在一种或多种药物与老年综合征相互作用。在 Shelter 项目中，288/373（77.2%）名跌倒患者、429/659（65.1%）名谵妄患者和 180/2765（6.5%）名尿失禁患者服用了一种或多种相互作用的药物。在 IBenC 项目中，78/172（45.3%）名跌倒患者、80/182（44.0%）名谵妄患者和 36/504（7.1%）名尿失禁患者服用了一种或多种相互作用的药物。
药物-老年综合征相互作用在长期护理患者中很常见。未来旨在改善长期护理环境中药物处方的研究和干预措施不仅应评估药物-药物和药物-疾病相互作用，还应评估涉及老年综合征的相互作用。
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