Mose Katrine, Lundby Carina, Ernst Martin Thomsen, Ryg Jesper, Pottegård Anton, Rasmussen Lotte
Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark.
Basic Clin Pharmacol Toxicol. 2025 Aug;137(2):e70076. doi: 10.1111/bcpt.70076.
Care home residents represent a frail population with limited life expectancy and are often prescribed multiple medications. As therapeutic goals shift in this population, certain treatments may become inappropriate. This study aims to describe potentially inappropriate medication use among Danish care home residents using the Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy (STOPPFrail) in a nationwide cohort of all Danish care home residents admitted 2015-2023, focusing on the time around admission and the last year of life. The cohort comprised 129 635 residents (61% women, median age 84 years). Around admission, 88% used at least one STOPPFrail medication, most commonly antihypertensives (58% before, 55% after), lipid-lowering therapies (31%, 27%) and proton-pump inhibitors (30%, 30%). The rate of new use increased from 2.6/100 residents/month 2 years before admission, peaking at 9.6/100 residents/month 2 months prior. Hospital physician prescribing increased as care home admission approached, after which general practitioners prescribed most prescriptions. Over 90% used at least one STOPPFrail medication during the last year of life, with increases in proton-pump inhibitors and antipsychotics, the latter most frequently initiated in the last 4 months. These findings underscore the importance of regular assessment and targeted efforts to improve prescribing appropriateness.
养老院居民是预期寿命有限的脆弱人群，常常被开具多种药物。随着该人群治疗目标的转变，某些治疗可能变得不再适宜。本研究旨在利用老年人预期寿命有限的虚弱成年人处方筛查工具（STOPPFrail），描述丹麦养老院居民中潜在不适当用药情况，研究对象为2015年至2023年全国范围内所有入住丹麦养老院的居民队列，重点关注入院前后及生命的最后一年。该队列包括129635名居民（61%为女性，中位年龄84岁）。入院前后，88%的居民使用至少一种STOPPFrail药物，最常见的是抗高血压药（入院前58%，入院后55%）、降脂疗法（31%，27%）和质子泵抑制剂（30%，30%）。新用药率从入院前2年的2.6/100居民/月上升，在入院前2个月达到峰值9.6/100居民/月。随着养老院入院临近，医院医生开的处方增加，之后大部分处方由全科医生开具。超过90%的居民在生命的最后一年使用至少一种STOPPFrail药物，质子泵抑制剂和抗精神病药物使用增加，抗精神病药物在最后4个月启动最为频繁。这些发现强调了定期评估和有针对性努力以提高处方适宜性的重要性。
