S Sandun M Silva, Nasir Wabe, Magdalena Z Raban, Amy D Nguyen, Guogui Huang, Ying Xu, Crisostomo Mercado, Desiree C Firempong, Johanna I Westbrook
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All medication incidents between 1 July 2014 and 31 August 2021 relating to 5709 aged care residents aged ≥ 65 years were included. The outcome measure was the medication incidence rate (IR), quantified as the number of medication incidents per 1000 resident days. A multilevel Poisson regression model was performed to identify risk factors associated with exposure to medication incidents.</p><p><strong>Results: </strong>A total of 5708 medication incidents were analysed. The overall medication IR was 1.81 per 1000 resident days (95% CI 1.76, 1.86). Of 5709 residents, 35% (n = 2016) had at least one recorded medication incident, of which 1095 (> 50%) had more than one. The majority of the incidents were associated with medication administration (3023 incidents, 53%), followed by supply (n = 1546, 27%) and monitoring the response to the medication (n = 548, 9.6%). The outcome of the incident on residents was reported in 5165 (90%) incidents, with 724 (14%) requiring the resident to be monitored by the hospital, general practitioner (GP), or staff. Respite admissions were associated with a higher risk of medication incidents including potentially harmful incidents, compared with permanent admissions (rate ratio (RR) = 1.908, 95% CI 1.646, 2.211, p < 0.01). Residents with Parkinson's disease had a 1.5-fold greater risk of a medication incident (RR = 1.586, 95% CI 1.318, 1.908) compared with residents without Parkinson's. The administration of more than five medications (polypharmacy) was associated with an increased risk of medication incidents (RR = 2.019, 95% CI 1.930, 2.111).</p><p><strong>Conclusions: </strong>Medication incidents affected more than one-third of older adults in RAC facilities. Improvement strategies should focus on medication administration, supply and monitoring, with particular attention given to respite residents and those with multimorbidity and polypharmacy.</p>","PeriodicalId":11382,"journal":{"name":"Drug Safety","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characteristics and Risk Factors of Medication Incidents Across Stages of Medication Management in Residential Aged Care: A Longitudinal Cohort Study of 5700 Reported Incidents.\",\"authors\":\"S Sandun M Silva, Nasir Wabe, Magdalena Z Raban, Amy D Nguyen, Guogui Huang, Ying Xu, Crisostomo Mercado, Desiree C Firempong, Johanna I Westbrook\",\"doi\":\"10.1007/s40264-025-01602-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Problems with medication management are consistently identified as key concerns for the quality of residential aged care (RAC). 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A multilevel Poisson regression model was performed to identify risk factors associated with exposure to medication incidents.</p><p><strong>Results: </strong>A total of 5708 medication incidents were analysed. The overall medication IR was 1.81 per 1000 resident days (95% CI 1.76, 1.86). Of 5709 residents, 35% (n = 2016) had at least one recorded medication incident, of which 1095 (> 50%) had more than one. The majority of the incidents were associated with medication administration (3023 incidents, 53%), followed by supply (n = 1546, 27%) and monitoring the response to the medication (n = 548, 9.6%). The outcome of the incident on residents was reported in 5165 (90%) incidents, with 724 (14%) requiring the resident to be monitored by the hospital, general practitioner (GP), or staff. 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引用次数: 0
摘要
背景:药物管理问题一直被认为是住宅老年护理(RAC)质量的关键问题。事件报告可以提供与药物管理相关的关键问题的宝贵信息;然而,很少有研究探讨RAC环境中的药物事件。目的:了解不同用药管理阶段的用药事件特点,并找出与用药事件相关的危险因素。方法:对澳大利亚新南威尔士州25家RAC机构的用药发生率数据进行回顾性纵向队列研究。纳入了2014年7月1日至2021年8月31日期间涉及5709名年龄≥65岁的老年护理居民的所有用药事件。结局指标为用药发生率(IR),量化为每1000住院日的用药事件数。采用多水平泊松回归模型确定与用药事件暴露相关的危险因素。结果:共分析5708例用药事件。总体用药IR为1.81 / 1000住客日(95% CI 1.76, 1.86)。在5709名居民中,35% (n = 2016)至少有一次记录的用药事件,其中1095人(50%)有一次以上的用药事件。大多数事件与给药有关(3023例,53%),其次是供应(n = 1546, 27%)和监测对药物的反应(n = 548, 9.6%)。在5165起(90%)事件中报告了对居民的事件结果,其中724起(14%)需要医院、全科医生(GP)或工作人员对居民进行监测。与长期住院相比,暂住院与包括潜在有害事件在内的较高用药事件风险相关(比率比(RR) = 1.908, 95% CI 1.646, 2.211, p < 0.01)。与没有帕金森病的居民相比,患有帕金森病的居民发生药物事件的风险高出1.5倍(RR = 1.586, 95% CI 1.318, 1.908)。使用5种以上药物(多药)与用药事件风险增加相关(RR = 2.019, 95% CI 1.930, 2.111)。结论:药物事件影响了RAC设施中超过三分之一的老年人。改进策略应侧重于药物管理、供应和监测,特别注意喘息期居民和多病多药患者。
Characteristics and Risk Factors of Medication Incidents Across Stages of Medication Management in Residential Aged Care: A Longitudinal Cohort Study of 5700 Reported Incidents.
Background: Problems with medication management are consistently identified as key concerns for the quality of residential aged care (RAC). Incident reports can provide valuable information on key issues related to medication management; however, few studies have explored medication incidents in RAC settings.
Objectives: To investigate the characteristics of medication incidents at different stages of medication management and identify the risk factors associated with incidents.
Methods: A retrospective longitudinal cohort study was conducted using medication incidence data from 25 RAC facilities in New South Wales, Australia. All medication incidents between 1 July 2014 and 31 August 2021 relating to 5709 aged care residents aged ≥ 65 years were included. The outcome measure was the medication incidence rate (IR), quantified as the number of medication incidents per 1000 resident days. A multilevel Poisson regression model was performed to identify risk factors associated with exposure to medication incidents.
Results: A total of 5708 medication incidents were analysed. The overall medication IR was 1.81 per 1000 resident days (95% CI 1.76, 1.86). Of 5709 residents, 35% (n = 2016) had at least one recorded medication incident, of which 1095 (> 50%) had more than one. The majority of the incidents were associated with medication administration (3023 incidents, 53%), followed by supply (n = 1546, 27%) and monitoring the response to the medication (n = 548, 9.6%). The outcome of the incident on residents was reported in 5165 (90%) incidents, with 724 (14%) requiring the resident to be monitored by the hospital, general practitioner (GP), or staff. Respite admissions were associated with a higher risk of medication incidents including potentially harmful incidents, compared with permanent admissions (rate ratio (RR) = 1.908, 95% CI 1.646, 2.211, p < 0.01). Residents with Parkinson's disease had a 1.5-fold greater risk of a medication incident (RR = 1.586, 95% CI 1.318, 1.908) compared with residents without Parkinson's. The administration of more than five medications (polypharmacy) was associated with an increased risk of medication incidents (RR = 2.019, 95% CI 1.930, 2.111).
Conclusions: Medication incidents affected more than one-third of older adults in RAC facilities. Improvement strategies should focus on medication administration, supply and monitoring, with particular attention given to respite residents and those with multimorbidity and polypharmacy.
期刊介绍:
Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes:
Overviews of contentious or emerging issues.
Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes.
In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area.
Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement.
Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics.
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