Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy.
Karolinska Institutet, Stockholm, Sweden.
Aging Clin Exp Res. 2021 Oct;33(10):2839-2847. doi: 10.1007/s40520-021-01797-z. Epub 2021 Feb 15.
1.5-8% of older adults live in nursing homes (NHs), presenting a high prevalence of frailty and polypharmacy.
To investigate the association of frailty with polypharmacy and drug prescription patterns in a sample of European Nursing Home (NH) residents.
Cross-sectional study based on the data from the Services and Health for Elderly in Long TERm care (SHELTER) study. 4121 NH residents in Europe and Israel. Residents' clinical, cognitive, social, and physical status were evaluated with the InterRAI LTCF tool, which allows comprehensive, standardized evaluation of persons living in NH. Polypharmacy and hyperpolypharmacy were defined as the concurrent use of ≥ 5 and ≥ 10 medications. Frailty was defined according to the FRAIL-NH scale.
Of 4121 participants, 46.6% were frail (mean age 84.6 ± 9.2 years; 76.4% female). Polypharmacy and hyperpolypharmacy were associated with a lower likelihood of frailty (Odds Ratio = 0.72; 95% CI = 0.59-0.87 and OR = 0.75; 95% CI = 0.60-0.94, respectively). Patterns of drug prescriptions were different between frail and non-frail residents. Symptomatic drugs (laxatives, paracetamol, and opioids) were more frequently prescribed among frail residents, while preventive drugs (bisphosphonates, vitamin D, and acetylsalicylic acid) were more frequently prescribed among non-frail residents.
Frailty is associated with less polypharmacy and with higher prevalence of symptomatic drugs use among NH residents. Further studies are needed to define appropriateness of drug prescription in frail individuals.
1.5%至 8%的老年人居住在养老院（NH）中，这些老年人普遍存在衰弱和多种药物治疗的情况。
调查衰弱与欧洲 NH 居民多种药物治疗和药物处方模式之间的关联。
基于 Services and Health for Elderly in Long TERm care（SHELTER）研究的数据进行的横断面研究。欧洲和以色列的 4121 名 NH 居民。居民的临床、认知、社会和身体状况使用 InterRAI LTCF 工具进行评估，该工具允许对居住在 NH 的人员进行全面、标准化的评估。同时使用≥5 种和≥10 种药物被定义为多种药物治疗和超多种药物治疗。衰弱根据 FRAIL-NH 量表定义。
在 4121 名参与者中，46.6%为衰弱（平均年龄 84.6±9.2 岁；76.4%为女性）。同时使用多种药物治疗和超多种药物治疗与衰弱的可能性降低相关（优势比=0.72；95%置信区间=0.59-0.87 和 OR=0.75；95%置信区间=0.60-0.94）。衰弱和非衰弱居民的药物处方模式不同。症状性药物（泻药、对乙酰氨基酚和阿片类药物）在衰弱居民中更常被开处，而预防性药物（双膦酸盐、维生素 D 和乙酰水杨酸）在非衰弱居民中更常被开处。
衰弱与 NH 居民的多种药物治疗减少和症状性药物使用的发生率增加相关。需要进一步研究来确定衰弱个体药物处方的适当性。
