Prevalence and Associated Factors of Polypharmacy in Nursing Home Residents: A Cross-Sectional Study.

Raquel Cadenas,Juan José García,María José Diez,Raquel Díez,Julen Susperregui,Cristina López,Matilde Sierra,Nélida Fernández,Ana M Sahagún

doi:10.3390/ijerph18042037

Raquel Cadenas, Juan José García + Show 7 more

Open Access

https://doi.org/10.3390/ijerph18042037

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Abstract

In Spain, there has been a progressive increase in aging. Specifically, Leon has been one of the Spanish provinces with the highest aging index. Polypharmacy is highly prevalent among the elderly, with significant consequences for safety. The aim of this study was to assess the consumption of drugs in a nursing home in the province of Leon and establish the relationship between polypharmacy and the most common comorbid diseases. A descriptive, observational, and cross-sectional study design was used. Residents’ information and treatments were collected by reviewing on medical charts, completed with clinical information obtained from the physician of the nursing home. The mean age of residents was 86.8 years, and 63.8% were female. Mean medical consumption amounted to 7.02 prescriptions. Polypharmacy was observed in 54.9% of residents, and excessive polypharmacy in 22.1%. The most commonly used medications (ATC classification) were those acting on the cardiovascular system (84.4%) and the nervous system (82.8%). A high-level of drug consumption was observed in the nursing home. Interventions should focus on those residents hospitalized the last year and with recent contact with a general practitioner. There is a need to develop a comprehensive monitoring system to assess the quality of prescriptions for nursing home residents.

Highlights

Aging is a global phenomenon that affects especially the most developed countries.In Spain, it is increasing dramatically: people aged 65 and over represented 19.1% of the Spanish population in 2017, with approximately one-third over 80 years (6.2% of the Spanish population)
Information on institutionalized elderly and their treatments were collected from January to June 2019 by one of the nurses of the Nursing home (NH), who reviewed on medical charts, completing it with clinical information obtained from the physician of the NH
Residents had mostly lived in the NH less than 5 years (52.2%), they had previously lived in their homes (65.9%), had contact in the past 2 months with a general practitioner (GP) (65.0%), and did not require hospitalization in the past 12 months (69.9%)

Summary

Introduction

In Spain, it is increasing dramatically: people aged 65 and over represented 19.1% of the Spanish population in 2017, with approximately one-third over 80 years (6.2% of the Spanish population). It is estimated that in 2050 Spanish population aged 65 and over will exceed 30%, and if only people aged 80 and over are considered, they will account for 12% of the Spanish population [1]. Castile-Leon is the region with the highest proportion of people over 64 years (24.4%) [2]. In this region, Leon is the second province with the highest aging index (2.41) in 2020 (calculated as the proportion between people over the age of 64 and under age 16) [3]. Complex and continuous process characterized by a rising susceptibility to the occurrence of multiple chronic diseases (comorbidity) that often results in the concomitant use of multiple drug therapies (polypharmacy) for treatment and prophylaxis

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