Department of Rehabilitation Medicine, Asahi Neurology and Rehabilitation Hospital, Matsudo City, Japan.
Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Geriatr Gerontol Int. 2021 May;21(5):386-391. doi: 10.1111/ggi.14145. Epub 2021 Feb 28.
We investigated the association between rehabilitation outcomes and polypharmacy, potentially inappropriate medications and potential prescribing omissions in older adults with fragility fractures.
In total, we registered 217 older adults with fragility fractures (hip or vertebral) retrospectively and examined the association between rehabilitation outcome and polypharmacy, potentially inappropriate medications and potential prescribing omissions. Polypharmacy was defined as five or more drugs. Potentially inappropriate medications and potential prescribing omissions were defined by the Beers criteria (2015) and the screening tool to alert to treatment criteria version 2, respectively. The outcome was functional independence measure gain (functional independence measure at discharge - functional independence measure at admission).
Multiple regression analyses revealed no association between functional independence measure gain and polypharmacy (crude: β = 0.058, P = 0.858; adjusted model: β = 0.013, P = 0.869) or potentially inappropriate medications (crude: β = 0.100, P = 0.144; adjusted model: β = 0.084, P = 0.260). However, there was a significant association between functional independence measure gain and potential prescribing omissions (crude: β = 0.167, P = 0.014; adjusted model: β = 0.180, P = 0.016). Participants without potential prescribing omissions (in other words, participants who were prescribed anti-osteoporosis drugs) had a greater functional independence measure gain than participants with potential prescribing omissions (in other words, those that were not prescribed anti-osteoporosis drugs).
To the best of our knowledge, this study is the first to report that participants without potential prescribing omissions had significantly improved rehabilitation outcomes. Geriatr Gerontol Int 2021; 21: 386-391.
我们调查了康复结果与老年人脆性骨折患者的药物多重用药、潜在不适当药物和潜在药物遗漏之间的关系。
我们共回顾性登记了 217 例脆性骨折(髋部或脊柱)老年患者,并检查了康复结果与药物多重用药、潜在不适当药物和潜在药物遗漏之间的关系。药物多重用药定义为使用五种或更多种药物。潜在不适当药物和潜在药物遗漏分别由 Beers 标准(2015 年)和治疗标准筛选工具 2 版定义。结果为功能独立性测量增益(出院时的功能独立性测量值-入院时的功能独立性测量值)。
多因素回归分析显示,功能独立性测量增益与药物多重用药(未调整模型:β=0.058,P=0.858;调整模型:β=0.013,P=0.869)或潜在不适当药物(未调整模型:β=0.100,P=0.144;调整模型:β=0.084,P=0.260)之间无相关性。然而,功能独立性测量增益与潜在药物遗漏之间存在显著相关性(未调整模型:β=0.167,P=0.014;调整模型:β=0.180,P=0.016)。无潜在药物遗漏(换句话说,给予抗骨质疏松药物的患者)患者的功能独立性测量增益明显大于有潜在药物遗漏(换句话说,未给予抗骨质疏松药物的患者)患者。
据我们所知,本研究首次报道无潜在药物遗漏的患者康复结果显著改善。老年医学与老年病学杂志 2021; 21: 386-391。