Evolution of potentially inappropriate medication use in nursing homes: Retrospective analysis of drug consumption data

Details

Serval ID
serval:BIB_3ED58E27BD31
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Evolution of potentially inappropriate medication use in nursing homes: Retrospective analysis of drug consumption data
Journal
Research in Social and Administrative Pharmacy
Author(s)
Cateau Damien, Bugnon Olivier, Niquille Anne
ISSN
1551-7411
Publication state
Published
Issued date
11/08/2020
Peer-reviewed
Oui
Language
english
Abstract
The use of potentially inappropriate medication (PIMs) is frequent in nursing homes (NHs), and leads to worsened health outcomes for their residents. Numerous initiatives to curb their use have been launched. Most studies of PIMs use in NHs, however, focused on their prevalence, and provide few insights on the evolution of their use.
Objective
The objective of this analysis is to measure the evolution of PIMs use in the nursing NHs of western Switzerland taking part in an integrated pharmacy service (IPS).
Methods
Drug consumption data from 166 NHs were collected for 2014 to 2018, through the monitoring of the IPS. These data were cross-referenced with validated PIMs lists (Beers’ list and Norwegian General Practice-Nursing Home, NORGEP-NH) to compute the number of potentially inappropriate defined daily doses per average resident (DDD/res) in each NH. Linear mixed-effects models were used to assess the evolution of PIMs use over time, following the NORGEP-NH classification of PIMs and the drug classes involved.
Results
In 2018, the number of DDD/res was 7.3 (SD 1.9); of those, 2.2 (SD 0.8) were potentially inappropriate. Psycholeptics, psychoanaleptics and antihypertenseives were the most-used PIMs. Between 2014 and 2018, the number of potentially inappropriate DDD/res decreased by 0.03 per year (CI95 [−0.05; −0.01]).
Conclusions
This study complements others that focused on the prevalence of PIMs use in NHs. The statistically significant reduction in the use of PIMs is an encouraging sign, but is probably not clinically meaningful for NH residents. With the growing concerns of the potential harms of these drugs, more specific interventions and implementation strategies need to be developed to help clinicians further reduce their use in NHs.
Keywords
Pharmaceutical Science, Pharmacy
Pubmed
Open Access
Yes
Funding(s)
Swiss National Science Foundation
Create date
19/08/2020 14:31
Last modification date
28/08/2020 6:26
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