Journal of the American Medical Directors Association
JAMDA OnlineOriginal StudyInappropriate Drug Prescription at Nursing Home Admission
Section snippets
Methods
This was a cross-sectional study of a convenience sample of all 106 patients older than 65 years who were admitted in 2008 to 6 skilled nursing homes of the same company in Valencia, Spain, with systematic review of all drugs that had been prescribed and were used at the time of nursing home admission, using the STOPP-START criteria and the Australian criteria. Age, gender, functional status (Barthel),36 mental status (Global Deterioration Scale),37 transfer location (from home, hospital, or a
Results
Data were available from 100 subjects: 5 refused to sign consent and 1 was found to be younger than 65 years. Mean age was 84.7 ± 7.5 years (79% were older than 80 years). Subjects were mostly women (80%), with a high degree of severe functional deterioration (42%); 23% had severe cognitive impairment. The average number of prescription drugs used was 6.49 per subject (Table 1).
Mean time needed to fill both the STOPP-START scale and the Australian scale was close to 3 minutes. Thirty-seven
Discussion
Inappropriate drug prescription is a frequent and serious problem among older people. In this study we used both the STOPP-START criteria and the Australian system in an older population, at the moment of admission to a nursing home, to evaluate their usefulness as a systematic means to detect potentially inappropriate prescription at this time. The Australian tool has not yet been properly validated.
Although more than half of our subjects were admitted directly from their homes, and therefore
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2021, Pharmacological ResearchCitation Excerpt :Nursing home residents use significantly more anticholinergic drugs than home-dwelling older people [6,7]. More than 30 % of nursing home residents use more than two drugs with anticholinergic activity, and 5% take more than five [8,9]. During hospital admission, the number of patients who receive drugs with anticholinergic activity increases [10], with more than 79 % of inpatients using one or more drugs with anticholinergic activity [11].
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The authors have declared no conflicts of interest.