دورية أكاديمية
Over- and under-prescribing, and their association with functional disability in older patients at risk of further decline in Germany – a cross-sectional survey conducted as part of a randomised comparative effectiveness trial
| العنوان: | Over- and under-prescribing, and their association with functional disability in older patients at risk of further decline in Germany – a cross-sectional survey conducted as part of a randomised comparative effectiveness trial |
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| المؤلفون: | Claudia Salm, Julia Sauer, Nadine Binder, Aline Pfefferle, Mario Sofroniou, Gloria Metzner, Erik Farin-Glattacker, Sebastian Voigt-Radloff, Andy Maun |
| المصدر: | BMC Geriatrics, Vol 22, Iss 1, Pp 1-10 (2022) |
| بيانات النشر: | BMC |
| سنة النشر: | 2022 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | inappropriate prescribing, potentially inappropriate medications, potential prescribing omissions, polypharmacy, multimorbidity, functional disability, Geriatrics, RC952-954.6 |
| الوصف: | Background Older patients at risk of functional decline are frequently affected by polypharmacy. This is associated with a further loss of independence. However, a relationship between functional disability and medications, such as ‘Potentially Inappropriate Medications’ (PIMs) and ‘Potential Prescribing Omissions’ (PPOs), as itemised for (de) prescribing in practice-orientated medication lists, has yet to be established. Methods As part of a randomised comparative effectiveness trial, LoChro, we conducted a cross-sectional analysis of the association between PIMs and PPOs measured using the ‘Screening Tool of Older Persons’ Prescription Criteria / Screening Tool To Alert to Right Treatment’ (STOPP/START) Version 2, with functional disability assessed using the ‘World Health Organization Disability Assessment Schedule 2.0’ (WHODAS). Individuals aged 65 and older at risk of loss of independence were recruited from the inpatient and outpatient departments of the local university hospital. Multiple linear regression analysis was used to model the potential prediction of functional disability using the numbers of PIMs and PPOs, adjusted for confounders including multimorbidity. Results Out of 461 patients, both the number of PIMs and the number of PPOs were significantly associated with an increase in WHODAS-score (Regression coefficients B 2.7 [95% confidence interval: 1.5-3.8] and 1.5 [95% confidence interval: 0.2-2.7], respectively). In WHODAS-score prediction modelling the contribution of the number of PIMs exceeded the one of multimorbidity (standardised coefficients beta: PIM 0.20; multimorbidity 0.13; PPO 0.10), whereas no significant association between the WHODAS-score and the number of medications was seen. 73.5 % (339) of the participants presented with at least one PIM, and 95.2% (439) with at least one PPO. The most common PIMs were proton pump inhibitors and analgesic medication, with frequent PPOs being pneumococcal and influenza vaccinations, as well as osteoporosis prophylaxis. Conclusions ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1471-2318 |
| العلاقة: | https://doi.org/10.1186/s12877-022-03242-wTest; https://doaj.org/toc/1471-2318Test; https://doaj.org/article/ddd005af925c41ea973a61a4322f3768Test |
| DOI: | 10.1186/s12877-022-03242-w |
| الإتاحة: | https://doi.org/10.1186/s12877-022-03242-wTest https://doaj.org/article/ddd005af925c41ea973a61a4322f3768Test |
| رقم الانضمام: | edsbas.51B1C3 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 14712318 |
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| DOI: | 10.1186/s12877-022-03242-w |