Skip to main content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Wiener Medizinische Wochenschrift 5-6/2016

01.04.2016 | main topic

Polypharmacy, potentially inappropriate medication and cognitive status in Austrian nursing home residents: results from the OSiA study

verfasst von: MD Reinhard Alzner, MA Ulrike Bauer, MA Stefan Pitzer, Maria Magdalena Schreier, PhD Jürgen Osterbrink, MD Bernhard Iglseder

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 5-6/2016

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

There is little research investigating polypharmacy and potentially inappropriate medications (PIM) in connection with cognitive status in residents of Austrian nursing homes. Our findings result from a cross-sectional survey of 425 residents (315 women, 110 men, mean 83.6 years) from 12 Austrian nursing homes. The number of systemically administered permanent prescription drugs was 8.99 ± 3.9 and decreased significantly with increasing cognitive impairment. Irrespective of cognitive status, polypharmacy (> 5 individual substances) was present in approximately 75 % of the residents. Hyper-polypharmacy (> 10 individual substances) was present among almost 50 % of the cognitively intact residents, and hence, significantly more frequent as compared with the group with the lowest cognitive performance (23.4 %). At least one PIM was found in 72.4 % of residents regardless of cognitive status. Predominantly, PIMs consisted of tranquilizers, antipsychotics, osmotic laxatives, non-steroidal anti-inflammatory drugs (NSAIDs) and anticholinergics, where only the number of NSAIDs decreased significantly with increasing cognitive impairment. In summary, our study shows a continued high prevalence of polypharmacy and PIM in long-term care institutions in Austria.
Literatur
2.
Zurück zum Zitat Onder G, Liperoti R, Fialová D, et al. Polypharmacy in nursing home in Europe: results from the SHELTER Study. J Gerontol A Biol Sci Med Sci. 2012;67A(6):698–704. CrossRef Onder G, Liperoti R, Fialová D, et al. Polypharmacy in nursing home in Europe: results from the SHELTER Study. J Gerontol A Biol Sci Med Sci. 2012;67A(6):698–704. CrossRef
3.
Zurück zum Zitat Doshi JA, Shaffer T, Briesacher BA, et al. National estimates of medication use in nursing homes: findings from the 1997 medicare current beneficiary survey and the 1996 medical expenditure survey. J Am Geriatr Soc. 2005;53:438–43. CrossRefPubMed Doshi JA, Shaffer T, Briesacher BA, et al. National estimates of medication use in nursing homes: findings from the 1997 medicare current beneficiary survey and the 1996 medical expenditure survey. J Am Geriatr Soc. 2005;53:438–43. CrossRefPubMed
4.
5.
Zurück zum Zitat Onder G, Gambassi G, Scales CJ, et al. Adverse drug reactions and cognitive function among hospitalized older adults. Eur J Clin Pharmacol. 2002;58:371–7. CrossRefPubMed Onder G, Gambassi G, Scales CJ, et al. Adverse drug reactions and cognitive function among hospitalized older adults. Eur J Clin Pharmacol. 2002;58:371–7. CrossRefPubMed
6.
Zurück zum Zitat Vetrano DL, Tosato M, Colloca G, et al. Polypharmacy in nursing home residents with severe cognitive impairment: results from the SHELTER Study. Alzheimers Dement. 2013;9:587–93. CrossRefPubMed Vetrano DL, Tosato M, Colloca G, et al. Polypharmacy in nursing home residents with severe cognitive impairment: results from the SHELTER Study. Alzheimers Dement. 2013;9:587–93. CrossRefPubMed
7.
Zurück zum Zitat Holt S, Schmiedl S, Thürmann PA. Potentially inappropriate medication in the elderly—PRISCUS list. Dtsch Arztebl Int. 2010;107:543–51. PubMedPubMedCentral Holt S, Schmiedl S, Thürmann PA. Potentially inappropriate medication in the elderly—PRISCUS list. Dtsch Arztebl Int. 2010;107:543–51. PubMedPubMedCentral
8.
Zurück zum Zitat Mann E, Böhmdorfer B, Frühwald T, et al. Potentially inappropriate medication in geriatric patients: the Austrian consensus panel list. Wien Klin Wochenschr. 2012;124(5–6):160–9. CrossRefPubMed Mann E, Böhmdorfer B, Frühwald T, et al. Potentially inappropriate medication in geriatric patients: the Austrian consensus panel list. Wien Klin Wochenschr. 2012;124(5–6):160–9. CrossRefPubMed
9.
Zurück zum Zitat Fialová D, Topinková E, Gambassi G, et al. Potentially inappropriate medication use among elderly home care patients in Europe. JAMA. 2005;293(11):1348–58. CrossRefPubMed Fialová D, Topinková E, Gambassi G, et al. Potentially inappropriate medication use among elderly home care patients in Europe. JAMA. 2005;293(11):1348–58. CrossRefPubMed
10.
Zurück zum Zitat Mann E, Haastert B, Böhmdorfer B, et al. Prevalence and associations of potentially inappropriate prescriptions in Austrian nursing home residents: secondary analysis of a cross-sectional study. Wien Klin Wochenschr. 2013;125:180–8. CrossRefPubMed Mann E, Haastert B, Böhmdorfer B, et al. Prevalence and associations of potentially inappropriate prescriptions in Austrian nursing home residents: secondary analysis of a cross-sectional study. Wien Klin Wochenschr. 2013;125:180–8. CrossRefPubMed
12.
Zurück zum Zitat Kaiser A, Gusner-Pfeiffer R, Griessenberger H, et al. Mini-Mental-State—Ein Screening in vielen Versionen. Z Gerontopsychol Psychiatr. 2009;22:11–6. Kaiser A, Gusner-Pfeiffer R, Griessenberger H, et al. Mini-Mental-State—Ein Screening in vielen Versionen. Z Gerontopsychol Psychiatr. 2009;22:11–6.
13.
Zurück zum Zitat Dwyer LL, Han B, Woodwell DA, Rechtsteiner EA. Polypharmacy in nursing home residents in the United States: results of the 2004 National Nursing Home Survey. Am J Geriatr Pharmacother. 2010;8(1):63–72. CrossRefPubMed Dwyer LL, Han B, Woodwell DA, Rechtsteiner EA. Polypharmacy in nursing home residents in the United States: results of the 2004 National Nursing Home Survey. Am J Geriatr Pharmacother. 2010;8(1):63–72. CrossRefPubMed
14.
Zurück zum Zitat Bronskill SE, Gill SS, Paterson JM, et al. Exploring variation in rates of polypharmacy across long-term care homes. J Am Med Dir Assoc. 2012;13(3):309.e15–21. CrossRef Bronskill SE, Gill SS, Paterson JM, et al. Exploring variation in rates of polypharmacy across long-term care homes. J Am Med Dir Assoc. 2012;13(3):309.e15–21. CrossRef
15.
Zurück zum Zitat Colloca G, Tosato M, Vetrano DL, Topinkova E, et al. Inappropriate drugs in elderly patients with severe cognitive impairment: results from the shelter study. PLoS One. 2012;7(10):e46669. CrossRefPubMedPubMedCentral Colloca G, Tosato M, Vetrano DL, Topinkova E, et al. Inappropriate drugs in elderly patients with severe cognitive impairment: results from the shelter study. PLoS One. 2012;7(10):e46669. CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Cool C, Cestac P, Laborde C, et al. Potentially inappropriate drug prescribing and associated factors in nursing homes. J Am Med Dir Assoc. 2014;15(11):850.e1–9. CrossRef Cool C, Cestac P, Laborde C, et al. Potentially inappropriate drug prescribing and associated factors in nursing homes. J Am Med Dir Assoc. 2014;15(11):850.e1–9. CrossRef
17.
Zurück zum Zitat Mann E, Köpke S, Haastert B, et al. Psychotropic medication use among nursing home residents in Austria: a cross-sectional study. BMC Geriatr. 2009;9:18. CrossRefPubMedPubMedCentral Mann E, Köpke S, Haastert B, et al. Psychotropic medication use among nursing home residents in Austria: a cross-sectional study. BMC Geriatr. 2009;9:18. CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Morrison RS, Siu AL. A comparison of pain and its treatment in advanced dementia and cognitively intact patients with hip fracture. J Pain Symptom Manage. 2000;19:240–8. CrossRefPubMed Morrison RS, Siu AL. A comparison of pain and its treatment in advanced dementia and cognitively intact patients with hip fracture. J Pain Symptom Manage. 2000;19:240–8. CrossRefPubMed
19.
Zurück zum Zitat Closs SJ, Barr B, Briggs M. Cognitive status and analgesic provision in nursing home residents. Br J Gen Pract. 2004;54(509):919–21. PubMedPubMedCentral Closs SJ, Barr B, Briggs M. Cognitive status and analgesic provision in nursing home residents. Br J Gen Pract. 2004;54(509):919–21. PubMedPubMedCentral
20.
Zurück zum Zitat Cornali C, Franzoni S, Gatti S, et al. Diagnosis of chronic pain caused by osteoarthritis and prescription of analgesics in patients with cognitive impairment. J Am Med Dir Assoc. 2006;7(1):1–5. CrossRefPubMed Cornali C, Franzoni S, Gatti S, et al. Diagnosis of chronic pain caused by osteoarthritis and prescription of analgesics in patients with cognitive impairment. J Am Med Dir Assoc. 2006;7(1):1–5. CrossRefPubMed
21.
Zurück zum Zitat Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults. Arch Intern Med. 2010;170:1648–54. CrossRefPubMed Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults. Arch Intern Med. 2010;170:1648–54. CrossRefPubMed
22.
Zurück zum Zitat Holmes HM, Sachs GA, Shega JW, et al. Integrating palliative medicine into the care of persons with advanced dementia: identifying appropriate medication use. J Am Geriatr Soc. 2008;56:1306–11. CrossRefPubMed Holmes HM, Sachs GA, Shega JW, et al. Integrating palliative medicine into the care of persons with advanced dementia: identifying appropriate medication use. J Am Geriatr Soc. 2008;56:1306–11. CrossRefPubMed
Metadaten
Titel
Polypharmacy, potentially inappropriate medication and cognitive status in Austrian nursing home residents: results from the OSiA study
verfasst von
MD Reinhard Alzner
MA Ulrike Bauer
MA Stefan Pitzer
Maria Magdalena Schreier
PhD Jürgen Osterbrink
MD Bernhard Iglseder
Publikationsdatum
01.04.2016
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 5-6/2016
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-015-0428-8

Weitere Artikel der Ausgabe 5-6/2016

Wiener Medizinische Wochenschrift 5-6/2016 Zur Ausgabe