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Polypharmacy in nursing home in Europe: results from the SHELTER study.
J Gerontol A Biol Sci Med Sci. 2012 Jun; 67(6):698-704.JG

Abstract

BACKGROUND

This study assesses prevalence and patients characteristics related to polypharmacy in a sample of nursing home residents.

METHODS

We conducted a cross-sectional analysis on 4,023 nursing home residents participating to the Services and Health for Elderly in Long TERm care (SHELTER) project, a study collecting information on residents admitted to 57 nursing home in 8 countries. Data were collected using the interRAI instrument for long-term care facilities. Polypharmacy status was categorized in 3 groups: non-polypharmacy (0-4 drugs), polypharmacy (5-9 drugs) and excessive polypharmacy (≥ 10 drugs).

RESULTS

Polypharmacy was observed in 2,000 (49.7%) residents and excessive polypharmacy in 979 (24.3%) residents. As compared with non-polypharmacy, excessive polypharmacy was directly associated not only with presence of chronic diseases but also with depression (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.38-2.37), pain (OR 2.31; 95% CI 1.80-2.97), dyspnoea (OR 2.29; 95% CI 1.61-3.27), and gastrointestinal symptoms (OR 1.73; 95% CI 1.35-2.21). An inverse association with excessive polypharmacy was shown for age (OR for 10 years increment 0.85; 95% CI 0.74-0.96), activities of daily living disability (OR for assistance required vs independent 0.90; 95% CI 0.64-1.26; OR for dependent vs independent 0.59; 95% CI 0.40-0.86), and cognitive impairment (OR for mild or moderate vs intact 0.64; 95% CI 0.47-0.88; OR for severe vs intact 0.39; 95% CI 0.26-0.57).

CONCLUSIONS

Polypharmacy and excessive polypharmacy are common among nursing home residents in Europe. Determinants of polypharmacy status include not only comorbidity but also specific symptoms, age, functional, and cognitive status.

Authors+Show Affiliations

Centro Medicina dell'Invecchiamento, Dipartimento di Scienze Gerontologiche, Geriatriche e Fisiatriche, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Roma, Italy. graziano_onder@rm.unicatt.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

22219520

Citation

Onder, Graziano, et al. "Polypharmacy in Nursing Home in Europe: Results From the SHELTER Study." The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 67, no. 6, 2012, pp. 698-704.
Onder G, Liperoti R, Fialova D, et al. Polypharmacy in nursing home in Europe: results from the SHELTER study. J Gerontol A Biol Sci Med Sci. 2012;67(6):698-704.
Onder, G., Liperoti, R., Fialova, D., Topinkova, E., Tosato, M., Danese, P., Gallo, P. F., Carpenter, I., Finne-Soveri, H., Gindin, J., Bernabei, R., & Landi, F. (2012). Polypharmacy in nursing home in Europe: results from the SHELTER study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 67(6), 698-704. https://doi.org/10.1093/gerona/glr233
Onder G, et al. Polypharmacy in Nursing Home in Europe: Results From the SHELTER Study. J Gerontol A Biol Sci Med Sci. 2012;67(6):698-704. PubMed PMID: 22219520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polypharmacy in nursing home in Europe: results from the SHELTER study. AU - Onder,Graziano, AU - Liperoti,Rosa, AU - Fialova,Daniela, AU - Topinkova,Eva, AU - Tosato,Matteo, AU - Danese,Paola, AU - Gallo,Pietro Folino, AU - Carpenter,Iain, AU - Finne-Soveri,Harriet, AU - Gindin,Jacob, AU - Bernabei,Roberto, AU - Landi,Francesco, AU - ,, Y1 - 2012/01/04/ PY - 2012/1/6/entrez PY - 2012/1/6/pubmed PY - 2012/7/24/medline SP - 698 EP - 704 JF - The journals of gerontology. Series A, Biological sciences and medical sciences JO - J. Gerontol. A Biol. Sci. Med. Sci. VL - 67 IS - 6 N2 - BACKGROUND: This study assesses prevalence and patients characteristics related to polypharmacy in a sample of nursing home residents. METHODS: We conducted a cross-sectional analysis on 4,023 nursing home residents participating to the Services and Health for Elderly in Long TERm care (SHELTER) project, a study collecting information on residents admitted to 57 nursing home in 8 countries. Data were collected using the interRAI instrument for long-term care facilities. Polypharmacy status was categorized in 3 groups: non-polypharmacy (0-4 drugs), polypharmacy (5-9 drugs) and excessive polypharmacy (≥ 10 drugs). RESULTS: Polypharmacy was observed in 2,000 (49.7%) residents and excessive polypharmacy in 979 (24.3%) residents. As compared with non-polypharmacy, excessive polypharmacy was directly associated not only with presence of chronic diseases but also with depression (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.38-2.37), pain (OR 2.31; 95% CI 1.80-2.97), dyspnoea (OR 2.29; 95% CI 1.61-3.27), and gastrointestinal symptoms (OR 1.73; 95% CI 1.35-2.21). An inverse association with excessive polypharmacy was shown for age (OR for 10 years increment 0.85; 95% CI 0.74-0.96), activities of daily living disability (OR for assistance required vs independent 0.90; 95% CI 0.64-1.26; OR for dependent vs independent 0.59; 95% CI 0.40-0.86), and cognitive impairment (OR for mild or moderate vs intact 0.64; 95% CI 0.47-0.88; OR for severe vs intact 0.39; 95% CI 0.26-0.57). CONCLUSIONS: Polypharmacy and excessive polypharmacy are common among nursing home residents in Europe. Determinants of polypharmacy status include not only comorbidity but also specific symptoms, age, functional, and cognitive status. SN - 1758-535X UR - https://www.unboundmedicine.com/medline/citation/22219520/Polypharmacy_in_nursing_home_in_Europe:_results_from_the_SHELTER_study_ L2 - https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glr233 DB - PRIME DP - Unbound Medicine ER -