Format

Send to

Choose Destination
Drugs Real World Outcomes. 2017 Dec;4(4):235-245. doi: 10.1007/s40801-017-0121-x.

Prevalence and Variability in Medications Contributing to Polypharmacy in Long-Term Care Facilities.

Author information

1
Faculty of Pharmacy and Pharmaceutical Sciences, Centre for Medicine Use and Safety, Monash University (Parkville Campus), 407 Royal Parade, Parkville, VIC, 3052, Australia. Natali.Jokanovic@monash.edu.
2
Pharmacy Department, Alfred Health, Melbourne, VIC, Australia. Natali.Jokanovic@monash.edu.
3
Faculty of Pharmacy and Pharmaceutical Sciences, Centre for Medicine Use and Safety, Monash University (Parkville Campus), 407 Royal Parade, Parkville, VIC, 3052, Australia.
4
Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
5
Pharmacy Department, Alfred Health, Melbourne, VIC, Australia.

Abstract

BACKGROUND:

Research into which medications contribute to polypharmacy and the variability in these medications across long-term care facilities (LTCFs) has been minimal.

OBJECTIVE:

Our objective was to investigate which medications were more prevalent among residents with polypharmacy and to determine the variability in prescribing of these medications across LTCFs.

METHODS:

This was a cross-sectional study of 27 LTCFs in regional and rural Victoria, Australia. An audit of the medication charts and medical records of 754 residents was performed in May 2015. Polypharmacy was defined as nine or more regular medications. Logistic regression was performed to determine the association between medications and resident characteristics with polypharmacy. Analyses were adjusted for age, sex and Charlson's comorbidity index. Variability in the use of the ten most prevalent medication classes was explored using funnel plots. Characteristics of LTCFs with low (< 30%), moderate (30-49%) and high (≥ 50%) polypharmacy prevalence were compared.

RESULTS:

Polypharmacy was observed in 272 (36%) residents. In adjusted analyses, each of the top ten most prevalent medication classes, with the exception of antipsychotics, were associated with polypharmacy. Between 7 and 23% of LTCFs fell outside the 95% control limits for each of the ten most prevalent medications. LTCFs with ≥ 50% polypharmacy prevalence were predominately smaller.

CONCLUSION:

Polypharmacy was associated with nine of the ten most prevalent medication classes. There was greater than fourfold variability in nine of the ten most prevalent medications across LTCFs. Further studies are needed to investigate the clinical appropriateness of the variability in polypharmacy.

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center