Variation in the potentially inappropriate use of antipsychotic and benzodiazepine medications among individuals receiving residential medication management reviews.

IF 1.5 Q3 PHARMACOLOGY & PHARMACY
Mouna J Sawan, Alexander J Clough, Jodie Hillen, Andrew R Zullo, Daniela C Moga, Natalie Soulsby, Danijela Gnjidic
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Abstract

Objectives: To describe the variation in the use of potentially inappropriate antipsychotic and benzodiazepine medications in residents who have received a medication review and to evaluate the extent to which this variation is associated with aged care home (ACH) and resident characteristics.

Methods: This cross-sectional, retrospective study used pharmacist-extracted data from 15,442 residents across 342 Australian ACHs who had a medication review during 2019. The proportion of residents receiving ≥1 potentially inappropriate antipsychotic and benzodiazepine medication according to Beers criteria were classified into quintiles by facility usage (Q1-Q5). Quintile characteristics were compared using descriptive analysis of facility and resident data. Logistic regression was used to compare individual usage between residents in each quintile adjusting for facility and resident characteristics.

Key findings: The cohort had mean age 85 years (SD ±9), with less than 14% of residents in Q1 (n = 68), and >31% of residents in Q5 (n = 68) using an antipsychotic. For benzodiazepines, these proportions were <19% in Q1 (n = 68) and >45% in Q5 (n = 67). Facilities in major cities were significantly more likely to report antipsychotic (Q1:74% vs Q5:88%, P = .03) and benzodiazepine use (Q1:69% vs Q5:87%, P = .015). Residents in Q5 were seven times more likely to be prescribed an antipsychotic (aOR:7.22, 95% CI:5.93-8.79) than residents in Q1, and eight times more likely to be prescribed a benzodiazepine (aOR:8.57, 95% CI 7.33-10.01, P < .001) than residents in Q1.

Conclusions: Significant variation exists in potentially inappropriate antipsychotic and benzodiazepine use among ACH residents receiving a medication review highlighting the need for further research to reduce prescribing of these high-risk medications.

在接受住院药物管理审查的个体中,抗精神病药物和苯二氮卓类药物的潜在不适当使用的差异。
目的:描述接受药物审查的居民在使用可能不适当的抗精神病药物和苯二氮卓类药物方面的变化,并评估这种变化在多大程度上与养老院(ACH)和居民特征相关。方法:这项横断面回顾性研究使用了药剂师提取的数据,这些数据来自342个澳大利亚地区的15442名居民,他们在2019年接受了药物审查。根据Beers标准接受≥1种可能不适当的抗精神病药物和苯二氮卓类药物的居民比例按设施使用情况分为五分位数(Q1-Q5)。采用描述性分析比较设施和居民资料的五分位数特征。采用Logistic回归比较各五分位数居民的个人使用情况,调整了设施和居民特征。主要发现:该队列的平均年龄为85岁(SD±9),第一季度少于14% (n = 68)的居民使用抗精神病药物,第5季度少于31% (n = 68)的居民使用抗精神病药物。对于苯二氮卓类药物,Q5中这些比例为45% (n = 67)。主要城市的医疗机构更有可能报告使用抗精神病药物(Q1:74% vs Q5:88%, P = 0.03)和苯二氮卓类药物(Q1:69% vs Q5:87%, P = 0.015)。Q5的居民比Q1的居民开抗精神病药的可能性高7倍(aOR:7.22, 95% CI:5.93-8.79),比Q1的居民开苯二氮卓类药物的可能性高8倍(aOR:8.57, 95% CI 7.33-10.01, P < .001)。结论:在接受药物审查的ACH患者中,潜在不适当的抗精神病药和苯二氮卓类药物的使用存在显著差异,强调需要进一步研究以减少这些高风险药物的处方。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
5.60%
发文量
146
期刊介绍: The International Journal of Pharmacy Practice (IJPP) is a Medline-indexed, peer reviewed, international journal. It is one of the leading journals publishing health services research in the context of pharmacy, pharmaceutical care, medicines and medicines management. Regular sections in the journal include, editorials, literature reviews, original research, personal opinion and short communications. Topics covered include: medicines utilisation, medicine management, medicines distribution, supply and administration, pharmaceutical services, professional and patient/lay perspectives, public health (including, e.g. health promotion, needs assessment, health protection) evidence based practice, pharmacy education. Methods include both evaluative and exploratory work including, randomised controlled trials, surveys, epidemiological approaches, case studies, observational studies, and qualitative methods such as interviews and focus groups. Application of methods drawn from other disciplines e.g. psychology, health economics, morbidity are especially welcome as are developments of new methodologies.
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