Prevalence and Duration of Use of Medicines Recommended for Short-Term Use in Aged Care Facility Residents.

appropriate medication use inappropriate medication use medication review nursing home older people over prescribing potentially inappropriate medicines residential aged care facility

Journal

Pharmacy (Basel, Switzerland)
ISSN: 2226-4787
Titre abrégé: Pharmacy (Basel)
Pays: Switzerland
ID NLM: 101678532

Informations de publication

Date de publication:
06 Jun 2019
Historique:
received: 21 05 2019
revised: 04 06 2019
accepted: 05 06 2019
entrez: 9 6 2019
pubmed: 9 6 2019
medline: 9 6 2019
Statut: epublish

Résumé

Multiple studies have assessed the appropriateness of the use of medicines for nursing home residents; however, few have included duration of use in their assessment. The aim of this study was to assess the level and duration of use of medications recommended for short-term use in residents of aged care facilities in Australia. Australian Government Department of Veterans' Affairs (DVA) administrative claims data were used for this study. Veterans eligible for all health services subsidised by DVA were followed for one year from 1 July 2015 to 30 June 2016. The number of days covered for each medicine was calculated by multiplying the number of prescriptions dispensed during the year by the pack duration for the medicine. The pack duration was calculated by dividing the quantity supplied at each dispensing by the usual number of doses per day in older people according to Australian prescribing guidelines. The proportion of patients using each medicine and the number of days covered during the study period were determined. 14, 237 residents met the inclusion criteria. One in five participants were dispensed antipsychotics, and the median duration of use was 180 days in the one-year period. More than one-third were dispensed a benzodiazepine, and the median duration of use was 240 days in the year. Half were dispensed an opioid analgesic with a median duration of use of 225 days in the year. Fifty-two percent were dispensed proton pump inhibitors with a median duration of use of 360 days in the year. A quarter received an antibiotic recommended for the management of urinary tract infection, with a median duration of use of 14 days in the year. Long-term use of antipsychotics, benzodiazepines, opioid analgesics and proton pump inhibitors is common in aged care residents. Ensuring appropriate duration of use for these medicines is necessary to reduce risk of harm.

Sections du résumé

BACKGROUND BACKGROUND
Multiple studies have assessed the appropriateness of the use of medicines for nursing home residents; however, few have included duration of use in their assessment. The aim of this study was to assess the level and duration of use of medications recommended for short-term use in residents of aged care facilities in Australia.
METHODS METHODS
Australian Government Department of Veterans' Affairs (DVA) administrative claims data were used for this study. Veterans eligible for all health services subsidised by DVA were followed for one year from 1 July 2015 to 30 June 2016. The number of days covered for each medicine was calculated by multiplying the number of prescriptions dispensed during the year by the pack duration for the medicine. The pack duration was calculated by dividing the quantity supplied at each dispensing by the usual number of doses per day in older people according to Australian prescribing guidelines. The proportion of patients using each medicine and the number of days covered during the study period were determined.
RESULTS RESULTS
14, 237 residents met the inclusion criteria. One in five participants were dispensed antipsychotics, and the median duration of use was 180 days in the one-year period. More than one-third were dispensed a benzodiazepine, and the median duration of use was 240 days in the year. Half were dispensed an opioid analgesic with a median duration of use of 225 days in the year. Fifty-two percent were dispensed proton pump inhibitors with a median duration of use of 360 days in the year. A quarter received an antibiotic recommended for the management of urinary tract infection, with a median duration of use of 14 days in the year.
CONCLUSION CONCLUSIONS
Long-term use of antipsychotics, benzodiazepines, opioid analgesics and proton pump inhibitors is common in aged care residents. Ensuring appropriate duration of use for these medicines is necessary to reduce risk of harm.

Identifiants

DOI: 10.3390/pharmacy7020055 PMID: 31174405 PMC: PMC6631023
pubmed: 31174405
pii: pharmacy7020055
doi: 10.3390/pharmacy7020055
pmc: PMC6631023
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Lisa M Kalisch Ellett (LM)

Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. lisa.kalisch@unisa.edu.au.

Gizat M Kassie (GM)

Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. gizat.kassie@unisa.edu.au.

Nicole L Pratt (NL)

Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Nicole.Pratt@unisa.edu.au.

Mhairi Kerr (M)

Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Mhairi.Kerr@unisa.edu.au.

Elizabeth E Roughead (EE)

Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Libby.Roughead@unisa.edu.au.

Classifications MeSH