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Internal and emergency medicine
Jan, 2022;17 (1): 165-171.

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

Laura Calcaterra, Marco Proietti, Edoardo Saporiti, Vanessa Nunziata, Yves Rolland, Bruno Vellas, Matteo Cesari
Author Information
  1. Laura Calcaterra: Geriatric Specialty Training School, University of Milan, Milan, Italy.
  2. Marco Proietti: Geriatric Unit, Fondazione IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138, Milan, Italy. marco.proietti@unimi.it. ORCID
  3. Edoardo Saporiti: Geriatric Specialty Training School, University of Milan, Milan, Italy.
  4. Vanessa Nunziata: Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy.
  5. Yves Rolland: Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.
  6. Bruno Vellas: Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.
  7. Matteo Cesari: Geriatric Unit, Fondazione IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138, Milan, Italy.
PMID: 34546497 DOI: 10.1007/s11739-021-02841-6

Abstract

Polypharmacy 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.

Keywords

Drugs Frailty Nursing homes Older persons Polypharmacy

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MeSH Term

Aged
Aged, 80 and over
Drug Prescriptions
Female
Frailty
Humans
Linear Models
Male
Nursing Homes
Polypharmacy
Journal Article
Article has an altmetric score of 16

Word Cloud

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