Goutan-Roura Ester, Carneiro Geovanna O, Moreira Francisca S M, Masó-Aguado Montse, Moreno-Martin Pau, Minobes-Molina Eduard, Skelton Dawn A, Jerez-Roig Javier
Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain.
Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
PeerJ. 2025 Jul 8;13:e19570. doi: 10.7717/peerj.19570. eCollection 2025.
Institutionalized residents tend to use more drugs and in larger doses. Potentially inappropriate medications (PIM) use is highly prevalent among them. In addition, they are more likely to be prescribed multiple medications (polypharmacy). Moreover, many drugs considered PIM have increased anticholinergic burden (ACB), responsible for adverse drug events (ADE).
Identifying PIM, polypharmacy and ACB among older people's prescriptions as well as their associated factors.
Cross-sectional observational multicentre study. Drug information was collected from the nursing homes, medical registers. PIM exposure was assessed using Beers Criteria 2023. ACB was calculated using the Anticholinergic Risk Scale. Other sociodemographic, as well as health-related data were also collected.
130 residents (83.8% women) mean age 85.1 (±7.4). Over 80% (111) of residents have prescriptions including at least one PIM. Polypharmacy (≥5 drugs) occurred in 69.1% (94), while extensive polypharmacy (≥10 drugs) occurred in 18.4% (25). The most prevalent PIMs were benzodiazepines (57.3%; 73), antipsychotics (48.5%; 66) and proton pump inhibitors (39.7%; 54). Regarding ACB, 63.1% (82) of the residents have prescriptions including at least one anticholinergic drug. In the multivariate analysis, ACB ( = 0.018; OR 3.52) and polypharmacy (p=0.015; OR 3.58) were associated with PIM.
The prevalence of PIM, polypharmacy and ACB was very high (84%, 69%, and 63% respectively) in this sample of nursing home residents. ACB and polypharmacy were significantly associated with PIM. Anticholinergic drugs should be carefully assessed and gradually withdrawn when not needed. Balancing treatment with other biopsychosocial interventions may contribute to reducing polypharmacy.
机构化居住的居民往往使用更多药物且剂量更大。潜在不适当用药（PIM）在他们当中非常普遍。此外，他们更有可能被开具多种药物（多重用药）。而且，许多被视为PIM的药物具有增加的抗胆碱能负担（ACB），这会导致药物不良事件（ADE）。
识别老年人处方中的PIM、多重用药和ACB及其相关因素。
横断面观察性多中心研究。从养老院、医疗记录中收集药物信息。使用2023年Beers标准评估PIM暴露情况。使用抗胆碱能风险量表计算ACB。还收集了其他社会人口学以及与健康相关的数据。
130名居民（83.8%为女性），平均年龄85.1岁（±7.4）。超过80%（111名）的居民有包含至少一种PIM的处方。多重用药（≥5种药物）发生在69.1%（94名）的居民中，而广泛多重用药（≥10种药物）发生在18.4%（25名）的居民中。最常见的PIM是苯二氮䓬类药物（57.3%；73名）、抗精神病药物（48.5%；66名）和质子泵抑制剂（39.7%；54名）。关于ACB，63.1%（82名）的居民有包含至少一种抗胆碱能药物的处方。在多变量分析中，ACB（=0.018；比值比3.52）和多重用药（p=0.015；比值比3.58）与PIM相关。
在这个养老院居民样本中，PIM、多重用药和ACB的患病率非常高（分别为84%、69%和63%）。ACB和多重用药与PIM显著相关。抗胆碱能药物在不需要时应仔细评估并逐渐停用。将治疗与其他生物心理社会干预措施相平衡可能有助于减少多重用药。
