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Scand J Prim Health Care. 2012 Sep;30(3):169-75. doi: 10.3109/02813432.2012.704813. Epub 2012 Jul 25.

Inappropriate prescribing for older people admitted to an intermediate-care nursing home unit and hospital wards.

Author information

  • 1Kavli Research Centre for Ageing and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway. Marit.Bakken@isf.uib.no

Abstract

OBJECTIVE:

To identify inappropriate prescribing among older patients on admission to and discharge from an intermediate-care nursing home unit and hospital wards, and to compare changes during stay within and between these groups.

DESIGN:

Observational study.

SETTING AND SUBJECTS:

Altogether 400 community-dwelling people aged ≥ 70 years, on consecutive emergency admittance to hospital wards of internal medicine and orthopaedic surgery, were randomized to an intermediate-care nursing home unit or hospital wards; 290 (157 at the intermediate-care nursing home unit and 133 in hospital wards) were eligible for this sub-study.

MAIN OUTCOME MEASURES:

Prevalence on admission and discharge of potentially inappropriate medications (Norwegian general practice [NORGEP] criteria) and drug-drug interactions; changes during stay.

RESULTS:

The mean (SD) age was 84.7 (6.2) years; 71% were women. From admission to discharge, the mean numbers of drugs prescribed per person increased from 6.0 (3.3) to 9.3 (3.8), p < 0.01. The prevalence of potentially inappropriate medications increased from 24% to 35%, p < 0.01; concomitant use of ≥ 3 psychotropic/opioid drugs and drug combinations including non-steroid anti-inflammatory drugs (NSAIDs) increased significantly. Serious drug-drug interactions were scarce both on admission and discharge (0.7%).

CONCLUSIONS:

Inappropriate prescribing was prevalent among older people acutely admitted to hospital, and the prevalence was not reduced during stay at an intermediate-care nursing home unit specially designed for these patients.

PMID:
22830533
[PubMed - indexed for MEDLINE]
PMCID:
PMC3443941
Free PMC Article
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