scholarly journals Predictors of drug prescription in nursing home residents: results from the INCUR study

2021 ◽  
Author(s):  
Laura Calcaterra ◽  
Marco Proietti ◽  
Edoardo Saporiti ◽  
Vanessa Nunziata ◽  
Yves Rolland ◽  
...  
Keyword(s):  
Nursing Home ◽  
Older Persons ◽  
Drug Prescription ◽  
Frailty Index ◽  
Nursing Home Residents ◽  
Public Health Issue ◽  
Linear Regression Models ◽  
The Mean ◽  
Independent Association ◽  
Post Hoc

AbstractPolypharmacy represents a major clinical and public health issue in older persons. We aimed to measure the prevalence of polypharmacy, and the main predictors of drug prescription in nursing home residents. Post hoc analyses of the “Incidence of pNeumonia and related ConseqUences in nursing home Residents” (INCUR) study were conducted. Polypharmacy was defined as the prescription of 5 or more drugs. A frailty index (FI) was computed according to the model proposed by Rockwood and Mitnitski using 36 health deficits, including diseases, signs, symptoms, and disabilities. Linear regression models were performed to identify the main predictors of the number of prescribed drugs. The INCUR study enrolled 800 patients (mean [SD] age 86.2 [4.1] years, 74.1% women). The mean number of medications prescribed at the baseline was 8.5 (SD 4.1). Prevalence of polypharmacy was found 86.4%. The mean FI was 0.38 (SD 0.10). A fully adjusted linear multivariate regression model found an inverse and independent association between age and number of prescribed drugs (beta − 0.07, 95% CI − 0.13, − 0.02; p = 0.005). Conversely, the FI was independently and positively associated with the number of medications (beta 4.73, 95% CI 1.17, 8.29; p = 0.009). The prevalence of polypharmacy is high among older persons living in nursing home. Age and FI are significantly associated with the number of drugs. The number of prescribed drugs tends to decrease with age, whereas a direct association with frailty is reported.

A Longitudinal Analysis of Functional Disability, Recovery, and Nursing Home Utilization After Hospitalization for Ambulatory Care Sensitive Conditions Among Community-Living Older Persons

2021 ◽  
Vol 16 (8) ◽  
Author(s):  
Cameron J Gettel ◽  
Arjun K Venkatesh ◽  
Linda S Leo-Summers ◽  
Terrence E Murphy ◽  
Evelyne A Gahbauer ◽  
...  
Keyword(s):  
Nursing Home ◽  
Ambulatory Care ◽  
Functional Recovery ◽  
Older Persons ◽  
Functional Disability ◽  
Ambulatory Care Sensitive Conditions ◽  
Disability Score ◽  
Patient Reported ◽  
The Mean ◽  
Monthly Probability

BACKGROUND/OBJECTIVE: Hospitalizations for ambulatory care sensitive conditions (ACSCs) are considered potentially preventable. With little known about the functional outcomes of older persons after ACSC-related hospitalizations, our objectives were to describe: (1) the 6-month course of postdischarge functional disability, (2) the cumulative monthly probability of functional recovery, and (3) the cumulative monthly probability of incident nursing home (NH) admission. METHODS: The analytic sample included 251 ACSC-related hospitalizations from a cohort of 754 nondisabled, community-living persons aged 70 years and older who were interviewed monthly for up to 19 years. Patient-reported disability scores in basic, instrumental, and mobility activities ranged from 0 to 13. Functional recovery was defined as returning within 6 months of discharge to a total disability score less than or equal to that immediately preceding hospitalization. RESULTS: The mean age was 85.1 years, and the mean disability score was 5.4 in the month prior to the ACSC-related hospitalization. After the ACSC-related hospitalization, total disability scores peaked at month 1 and improved modestly over the next 5 months, but remained greater than the pre-hospitalization score. Functional recovery was achieved by 70% of patients, and incident NH admission was experienced by 50% within 6 months after the 251 ACSC-related hospitalizations. CONCLUSIONS: During the 6 months after an ACSC-related hospitalization, older persons exhibited total disability scores that were higher than those immediately preceding hospitalization, with 3 of 10 not achieving functional recovery and half experiencing incident NH admission. These findings provide evidence that older persons experience clinically meaningful adverse patient-reported outcomes after ACSC-related hospitalizations.

Psychotropic Drug Prescription in Patients with Dementia: Nursing Home Residents Versus Patients Living at Home

2015 ◽  
Vol 49 (3) ◽  
pp. 671-680 ◽  
Author(s):  
Agnès Jacquin-Piques ◽  
Guillaume Sacco ◽  
Neda Tavassoli ◽  
Olivier Rouaud ◽  
Yannick Bejot ◽  
...  
Keyword(s):  
Nursing Home ◽  
Psychotropic Drug ◽  
Drug Prescription ◽  
Nursing Home Residents ◽  
At Home

scholarly journals Frailty Index and Quality of Life in Nursing Home Residents: Results From INCUR Study

2015 ◽  
Vol 71 (3) ◽  
pp. 420-424 ◽  
Author(s):  
Bertrand Fougère ◽  
Eirini Kelaiditi ◽  
Emiel O. Hoogendijk ◽  
Laurent Demougeot ◽  
Marilyne Duboué ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Frailty Index ◽  
Nursing Home Residents

scholarly journals The Edinburgh Feeding Evaluation in Dementia Scale: A Longitudinal Study in Nursing Home Residents

2017 ◽  
Vol 44 (3-4) ◽  
pp. 196-202 ◽  
Author(s):  
Roger Watson ◽  
Annamaria Bagnasco ◽  
Gianluca Catania ◽  
Giuseppe Aleo ◽  
Milko Zanini ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Time Points ◽  
Test Information ◽  
Fit Statistics ◽  
Item Fit ◽  
Mokken Scaling ◽  
Scaling Methods ◽  
The Mean ◽  
Test Information Function

Aims/Background: The Edinburgh Feeding Evaluation in Dementia (EdFED) scale has been shown to have good psychometric properties using a range of methods including Mokken scaling. We aimed to study the Italian version of the EdFED using Mokken scaling. Methods: Data were gathered at 7 time points from 401 nursing home residents affected by dementia in the course of a 6-month intervention study using analysis of variance, Mokken scaling, and person-item fit statistics. Results: The properties of the EdFED-I scale were stable over the course of the study with 4 items showing invariant item ordering at all time points. Some items behaved differently at different levels of difficulty in the scale and also depending on the mean level of feeding difficulty. The test information function showed a dip in the mid-range of difficulty scores.

Inappropriate drug prescription in elderly nursing home residents

2014 ◽  
Vol 24 (suppl_2) ◽  
Author(s):  
A Lafranconi ◽  
AM Maestroni ◽  
G Diana ◽  
P Ferraguti ◽  
C Lemma ◽  
...  
Keyword(s):  
Nursing Home ◽  
Drug Prescription ◽  
Nursing Home Residents ◽  
Inappropriate Drug

scholarly journals Potentially Inappropriate Drug Prescribing in French Nursing Home Residents: An Observational Study

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 133
Author(s):  
Soraya Qassemi ◽  
Arnaud Pagès ◽  
Laure Rouch ◽  
Serge Bismuth ◽  
André Stillmunkes ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Drug Prescription ◽  
Nursing Home Residents ◽  
Optimization Methods ◽  
Inappropriate Drug ◽  
Utilization Review ◽  
Cross Sectional ◽  
Implicit Approach ◽  
Explicit Criteria

Purpose: To identify the prevalence of potentially inappropriate drug prescription in a sample of nursing home residents in France, combining explicit criteria and implicit approach and to involve pharmacists in the multi-professional process of therapeutic optimization. Methods: A cross-sectional, observational, multicenter study was conducted during a five-month period in a sample of French nursing homes. Information on drug prescription, diseases, and socio-demographic characteristics of nursing home residents was collected. For each prescription, identification of potentially inappropriate drug prescription was done, based on explicit and implicit criteria. Results: Nursing home residents were administered an average of 8.1 (SD 3.2, range 0–20) drugs per day. Nearly 87% (n = 237) of the residents had polypharmacy with five or more drugs prescribed per day. Among the 274 nursing home residents recruited from five nursing homes, 212 (77.4%) had at least one potentially inappropriate drug prescription. According to the Laroche list, 84 residents (30.7%) had at least one drug with an unfavorable benefit–harm balance. An overdosing was found for 20.1% (n = 55) of the residents. Nearly 30% (n = 82) of the residents had a drug prescribed without valid medical indication. Conclusions: This study shows that potentially inappropriate drug prescriptions are highly prevalent among nursing home residents, nevertheless pharmacists can take part in drug utilization review in collaboration with the nursing home staff.

scholarly journals Frailty of Māori, Pasifika, and Non-Māori/Non-Pasifika Older People in New Zealand: A National Population Study of Older People Referred for Home Care Services

2020 ◽  
Author(s):  
Rebecca Abey-Nesbit ◽  
Nancye M Peel ◽  
Hector Matthews ◽  
Ruth E Hubbard ◽  
Prasad S Nishtala ◽  
...  
Keyword(s):  
New Zealand ◽  
Home Care ◽  
Older People ◽  
Frailty Index ◽  
Indigenous Populations ◽  
Potential Range ◽  
Linear Regression Models ◽  
Care Assessment ◽  
The Mean ◽  
Age And Sex

Abstract Background Little is known about the prevalence of frailty in indigenous populations. We developed a frailty index (FI) for older New Zealand Māori and Pasifika who require publicly funded support services. Methods An FI was developed for New Zealand adults aged 65 and older who had an interRAI Home Care assessment between June 1, 2012 and October 30, 2015. A frailty score for each participant was calculated by summing the number of deficits recorded and dividing by the total number of possible deficits. This created a FI with a potential range from 0 to 1. Linear regression models for FIs with ethnicity were adjusted for age and sex. Cox proportional hazards models were used to assess the association between the FI and mortality for Māori, Pasifika, and non-Māori/non-Pasifika. Results Of 54 345 participants, 3096 (5.7%) identified as Māori, 1846 (3.4%) were Pasifika, and 49 415 (86.7%) identified as neither Māori nor Pasifika. New Zealand Europeans (48 178, 97.5%) constituted most of the latter group. Within each sex, the mean FIs for Māori and Pasifika were greater than the mean FIs for non-Māori and non-Pasifika, with the difference being more pronounced in women. The FI was associated with mortality (Māori subhazard ratio [SHR] 2.53, 95% CI 1.63–3.95; Pasifika SHR 6.03, 95% CI 3.06–11.90; non-Māori and non-Pasifika SHR 2.86, 95% CI 2.53–3.25). Conclusions This study demonstrated differences in FI between the ethnicities in this select cohort. After adjustment for age and sex, increases in FI were associated with increased mortality. This suggests that FI is predictive of poor outcomes in these ethnic groups.

scholarly journals Accessing the discriminatory performance of FRAIL-NH in two-class and three-class frailty and examining its agreement with the frailty index among nursing home residents in mainland China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Feng Ge ◽  
Weiwei Liu ◽  
Minhui Liu ◽  
Siyuan Tang ◽  
Yongjin Lu ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Assessment Tool ◽  
Frailty Index ◽  
Mainland China ◽  
Nursing Home Residents ◽  
Kappa Statistics ◽  
Cross Sectional ◽  
Cutoff Points ◽  
Discriminatory Performance

Abstract Background FRAIL-NH has been commonly used to assess frailty in nursing home residents and validated in many ethnic populations; however, it has not been validated in mainland China, where such an assessment tool is lacking. This study aimed to (1) assess the discriminatory performance of FRAIL-NH in two-class frailty (non-frail+ pre-frail vs. frail) and three-class frailty (non-frail vs. pre-frail vs. frail), based on the Frailty Index (FI), (2) determine the appropriate cutoff points for FRAIL-NH that distinguish two-class and three-class frailty, and (3) examine the agreement in classification between FRAIL-NH and FI. Methods A cross-sectional study of 302 residents aged 60 years or older from six nursing homes in Changsha was conducted. The FRAIL-NH scale and 34-item FI were used to measure frailty. Two-way and three-way receiver operating characteristic (ROC) curves were used to estimate the performance of FRAIL-NH. Cohen’s Kappa statistics were used to examine the agreement between these two measures. Results The agreement between FRAIL-NH and FI ranged from 0.33 to 0.55. Regardless of what FI cutoff points were based on, the volume under the ROC surface (VUS) for FRAIL-NH from the three-way ROC were higher than the VUS of a useless test (1/6), and the area under the ROC curve (AUC) for FRAIL-NH from the two-way ROC were higher than the clinically meaningless value (0.5). When using FI cutoff points of 0.20 for pre-frail and 0.45 for frail, FRAIL-NH cutoff points of 1 and 9 in classifying three-class frailty had the highest VUS and the largest correct classification rates. Whichever FI was chosen, the performance of FRAIL-NH in distinguishing between pre-frailty and frailty, and between non-frailty and pre-frailty was equivalent. According to FRAIL-NH, the proportion of individuals with frailty misclassified as pre-frailty was higher than that of individuals with non-frailty misclassified as pre-frailty. Conclusion FRAIL-NH can be used as a preliminary frailty screening tool in nursing homes in mainland China. FI should be further used especially for those classified as pre-frailty by FRAIL-NH. It is not advisable to simply combine adjacent two classes of FRAIL-NH to create a new frailty variable in research settings.

Sign in / Sign up

Export Citation Format

Share Document