Haider Ibrahim, Kosari Sam, Naunton Mark, Niyonsenga Theo, Peterson Gregory M, Koerner Jane, Davey Rachel
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia.
Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia.
J Clin Med. 2022 Sep 1;11(17):5189. doi: 10.3390/jcm11175189.
Prescribing potentially inappropriate medications (PIMs), including antipsychotics and benzodiazepines, has been used as an indicator of the quality use of medicines in residential aged care facilities (RACFs). PIMs are associated with an increased risk of falls and hospitalisations in the elderly. The purpose of this study is to assess the extent of prescribing of PIMs in RACFs at baseline in the Pharmacists in residential aged care facilities (PiRACF) study and examine the association of resident and system factors with the number of PIMs. A cross-sectional analysis of 1368 participants from 15 Australian RACFs was performed to detect PIMs using the American Geriatrics Society 2019 Beers® criteria. Most residents (68.1%) were taking at least one regular PIM; 16.9% were taking regular antipsychotics and 11.1% were taking regular benzodiazepines. Long-term proton pump inhibitors were the most frequent class of PIMs. History of falls and higher Charlson Comorbidity Index were associated with an increased number of prescribed PIMs, while dementia diagnosis and older age (85 years or more) were associated with decreased number of PIMs (p-value <0.05). Residents in facilities with lower nurse-to-resident ratios were more likely to have an increased number of PIMs (p value = 0.001). This study indicates that potentially inappropriate prescribing is common in RACFs and interventions to target residents at highest risk are needed.
开具包括抗精神病药物和苯二氮䓬类药物在内的潜在不适当药物（PIMs），已被用作评估老年护理机构（RACFs）合理用药质量的一项指标。PIMs与老年人跌倒和住院风险增加相关。本研究的目的是评估在老年护理机构药师（PiRACF）研究中，RACFs在基线时开具PIMs的程度，并探讨居民因素和系统因素与PIMs数量之间的关联。使用美国老年医学会2019年Beers®标准，对来自15家澳大利亚RACFs的1368名参与者进行横断面分析，以检测PIMs。大多数居民（68.1%）至少服用一种常规PIM；16.9%服用常规抗精神病药物，11.1%服用常规苯二氮䓬类药物。长期质子泵抑制剂是最常见的PIMs类别。跌倒史和较高的查尔森合并症指数与开具的PIMs数量增加相关，而痴呆症诊断和高龄（85岁及以上）与PIMs数量减少相关（p值<0.05）。护士与居民比例较低的机构中的居民更有可能有更多的PIMs（p值 = 0.001）。本研究表明，潜在不适当处方在RACFs中很常见，需要针对风险最高的居民采取干预措施。
