UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Age Ageing. 2022 Jul 1;51(7). doi: 10.1093/ageing/afac149.
no studies have examined the impact of residential medication management review (RMMR, a 24-year government subsidised comprehensive medicines review program) in Australian residential aged care facilities (RACFs) on hospitalisation or mortality.
to examine associations between RMMR provision in the 6-12 months after RACF entry and the 12-month risk of hospitalisation and mortality among older Australians in RACFs.
retrospective cohort study.
individuals aged 65-105 years taking at least one medicine, who entered an RACF in three Australian states between 1 January 2012 and 31 December 2015 and spent at least 6 months in the RACF (n = 57,719).
Cox regression models estimated adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for associations between RMMR provision and mortality. Adjusted subdistribution hazard ratios were estimated for associations between RMMR provision and next (i) emergency department (ED) presentation or unplanned hospitalisation or (ii) fall-related ED presentation or hospitalisation.
there were 12,603 (21.8%) individuals who received an RMMR within 6-12 months of RACF entry, of whom 22.2% (95%CI 21.4-22.9) died during follow-up, compared with 23.3% (95%CI 22.9-23.7) of unexposed individuals. RMMR provision was associated with a lower risk of death due to any cause over 12-months (aHR 0.96, 95%CI 0.91-0.99), but was not associated with ED presentations or hospitalisations for unplanned events or falls.
provision of an RMMR in the 6-12 months after RACF entry is associated with a 4.4% lower mortality risk over 12-months but was not associated with changes in hospitalisations for unplanned events or falls.
目前尚无研究调查澳大利亚养老院中，住房药物管理审查（RMMR，一项 24 年政府补贴的全面药物审查计划）对住院或死亡的影响。
检验入住养老院后 6-12 个月内提供 RMMR 与入住养老院的澳大利亚老年人 12 个月内住院和死亡风险之间的关联。
回顾性队列研究。
2012 年 1 月 1 日至 2015 年 12 月 31 日期间，在澳大利亚三个州入住养老院且至少服用一种药物、年龄在 65-105 岁之间、在养老院中至少居住 6 个月的个人（n=57719）。
使用 Cox 回归模型，估计调整后的风险比（aHR）及其 95%置信区间（CI），以评估 RMMR 提供与死亡率之间的关联。估计了调整后的亚分布风险比，以评估 RMMR 提供与以下情况之间的关联：（i）下一次（急诊就诊或无计划住院）或（ii）与跌倒相关的急诊就诊或住院。
在入住养老院后 6-12 个月内，有 12603 人（21.8%）接受了 RMMR，其中 22.2%（95%CI 21.4-22.9）在随访期间死亡，而未接受 RMMR 的个体的死亡率为 23.3%（95%CI 22.9-23.7）。RMMR 的提供与 12 个月内任何原因导致的死亡风险降低相关（aHR 0.96，95%CI 0.91-0.99），但与因计划外事件或跌倒导致的急诊就诊或住院无关。
在入住养老院后 6-12 个月内提供 RMMR 可降低 12 个月内 4.4%的死亡率风险，但与因计划外事件或跌倒导致的住院率变化无关。
