Associations of potentially inappropriate medication use with four year survival of an inception cohort of nursing home residents.
Dementia
Nursing home
Polypharmacy
Potentially inappropriate medications
Survival analyses
Journal
Archives of gerontology and geriatrics
ISSN: 1872-6976
Titre abrégé: Arch Gerontol Geriatr
Pays: Netherlands
ID NLM: 8214379
Informations de publication
Date de publication:
Historique:
received:
31
08
2018
revised:
08
10
2018
accepted:
24
10
2018
pubmed:
6
11
2018
medline:
4
7
2019
entrez:
4
11
2018
Statut:
ppublish
Résumé
Survival in older adults has a high variability. The possible association of length of survival with potentially inappropriate medication (PIM) use remains unclear. To examine the four-year survival rate, the prevalence of polypharmacy and PIM use at admission, and the association between the two, in an inception cohort of newly admitted nursing home residents METHODS: Data were used from ageing@NH, a prospective observational cohort study in nursing homes. Residents (n = 613) were followed for four years after admission or until death. PIM use was measured at admission, using STOPPFrail. The Kaplan-Meier method was used to estimate survival, using log-rank tests for subgroup analyses. Cox regression analyses was used to explore associations with PIM use and polypharmacy, corrected for covariates RESULTS: Mean age was 84, 65% were females. After one, two, three and four years the survival rates were respectively 79%, 60.5%, 47% and 36%. At admission, 47% had polypharmacy and 40% excessive polypharmacy, 11% did not use any PIMs, and respectively 28%, 29%, and 32% used one, two and three or more PIMs. No difference in survival was found between polypharmacy and no polypharmacy, and PIM use and no PIM use at admission. Neither polypharmacy nor PIM use at admission were associated with mortality. Residents survived a relatively short time after NH admission. Polypharmacy and PIM use at admission were relatively high in this cohort, although neither was associated with mortality.
Sections du résumé
BACKGROUND
Survival in older adults has a high variability. The possible association of length of survival with potentially inappropriate medication (PIM) use remains unclear.
AIM
To examine the four-year survival rate, the prevalence of polypharmacy and PIM use at admission, and the association between the two, in an inception cohort of newly admitted nursing home residents METHODS: Data were used from ageing@NH, a prospective observational cohort study in nursing homes. Residents (n = 613) were followed for four years after admission or until death. PIM use was measured at admission, using STOPPFrail. The Kaplan-Meier method was used to estimate survival, using log-rank tests for subgroup analyses. Cox regression analyses was used to explore associations with PIM use and polypharmacy, corrected for covariates RESULTS: Mean age was 84, 65% were females. After one, two, three and four years the survival rates were respectively 79%, 60.5%, 47% and 36%. At admission, 47% had polypharmacy and 40% excessive polypharmacy, 11% did not use any PIMs, and respectively 28%, 29%, and 32% used one, two and three or more PIMs. No difference in survival was found between polypharmacy and no polypharmacy, and PIM use and no PIM use at admission. Neither polypharmacy nor PIM use at admission were associated with mortality.
CONCLUSION
Residents survived a relatively short time after NH admission. Polypharmacy and PIM use at admission were relatively high in this cohort, although neither was associated with mortality.
Identifiants
pubmed: 30390429
pii: S0167-4943(18)30204-8
doi: 10.1016/j.archger.2018.10.011
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
82-87Informations de copyright
Copyright © 2018 Elsevier B.V. All rights reserved.