Tags

Type your tag names separated by a space and hit enter

Exploring variation in rates of polypharmacy across long term care homes.
J Am Med Dir Assoc. 2012 Mar; 13(3):309.e15-21.JA

Abstract

OBJECTIVE

Use of multiple, concurrent drug therapies, often referred to as polypharmacy, is a concern in the long term care (LTC) setting, where frail older adults are particularly at risk for adverse events. We quantified the scope of this practice by exploring variation in the use of nine or more drug therapies across LTC homes.

DESIGN

Cross-sectional analysis of LTC home census data.

SETTING

All LTC homes in Ontario, Canada.

PARTICIPANTS

A total of 64,394 LTC residents aged 66 years and older residing in 589 LTC homes in the fall of 2005.

MEASUREMENTS

Facility-level rates of polypharmacy were compared with rates of use of Beers criteria and antipsychotic drug therapies. Multivariate logistic regression models were used to assess predictors of polypharmacy across residents and LTC homes.

RESULTS

Nine or more drug therapies were dispensed concurrently to 10,007 (15.5%) of LTC home residents. Compared with those dispensed fewer drugs, residents receiving 9 or more drug therapies were more likely to have multiple comorbidities. There was threefold variation in polypharmacy rates across homes (26.2% versus 7.9%) and facility-level rates of polypharmacy were modestly correlated with rates of use of Beers criteria drugs (r = 0.27, P < .001) and antipsychotic drug therapies (r = 0.16, P < .001). Controlling for resident factors, those living in LTC homes with high polypharmacy rates were more likely to receive 9 or more drug therapies (odds ratio 1.9, 95% confidence interval 1.7-2.0).

CONCLUSION

Residents in Ontario LTC homes commonly received nine or more concurrent drug therapies, particularly residents with multiple chronic conditions. The threefold variation in rate across homes suggests a role for this measure in guiding drug review at the facility level.

Authors+Show Affiliations

Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. susan.bronskill@ices.on.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21839687

Citation

Bronskill, Susan E., et al. "Exploring Variation in Rates of Polypharmacy Across Long Term Care Homes." Journal of the American Medical Directors Association, vol. 13, no. 3, 2012, pp. 309.e15-21.
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.
Bronskill, S. E., Gill, S. S., Paterson, J. M., Bell, C. M., Anderson, G. M., & Rochon, P. A. (2012). Exploring variation in rates of polypharmacy across long term care homes. Journal of the American Medical Directors Association, 13(3), e15-21. https://doi.org/10.1016/j.jamda.2011.07.001
Bronskill SE, et al. Exploring Variation in Rates of Polypharmacy Across Long Term Care Homes. J Am Med Dir Assoc. 2012;13(3):309.e15-21. PubMed PMID: 21839687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exploring variation in rates of polypharmacy across long term care homes. AU - Bronskill,Susan E, AU - Gill,Sudeep S, AU - Paterson,J Michael, AU - Bell,Chaim M, AU - Anderson,Geoffrey M, AU - Rochon,Paula A, Y1 - 2011/08/12/ PY - 2011/04/21/received PY - 2011/06/29/revised PY - 2011/07/01/accepted PY - 2011/8/16/entrez PY - 2011/8/16/pubmed PY - 2012/6/21/medline SP - 309.e15 EP - 21 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 13 IS - 3 N2 - OBJECTIVE: Use of multiple, concurrent drug therapies, often referred to as polypharmacy, is a concern in the long term care (LTC) setting, where frail older adults are particularly at risk for adverse events. We quantified the scope of this practice by exploring variation in the use of nine or more drug therapies across LTC homes. DESIGN: Cross-sectional analysis of LTC home census data. SETTING: All LTC homes in Ontario, Canada. PARTICIPANTS: A total of 64,394 LTC residents aged 66 years and older residing in 589 LTC homes in the fall of 2005. MEASUREMENTS: Facility-level rates of polypharmacy were compared with rates of use of Beers criteria and antipsychotic drug therapies. Multivariate logistic regression models were used to assess predictors of polypharmacy across residents and LTC homes. RESULTS: Nine or more drug therapies were dispensed concurrently to 10,007 (15.5%) of LTC home residents. Compared with those dispensed fewer drugs, residents receiving 9 or more drug therapies were more likely to have multiple comorbidities. There was threefold variation in polypharmacy rates across homes (26.2% versus 7.9%) and facility-level rates of polypharmacy were modestly correlated with rates of use of Beers criteria drugs (r = 0.27, P < .001) and antipsychotic drug therapies (r = 0.16, P < .001). Controlling for resident factors, those living in LTC homes with high polypharmacy rates were more likely to receive 9 or more drug therapies (odds ratio 1.9, 95% confidence interval 1.7-2.0). CONCLUSION: Residents in Ontario LTC homes commonly received nine or more concurrent drug therapies, particularly residents with multiple chronic conditions. The threefold variation in rate across homes suggests a role for this measure in guiding drug review at the facility level. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/21839687/abstract/Exploring_Variation_in_Rates_of_Polypharmacy_Across_Long_Term_Care_Homes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1525-8610(11)00258-1 DB - PRIME DP - Unbound Medicine ER -