Abstract
BackgroundThe prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan.MethodsWe conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC) facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria.ResultsThe patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1%) of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%). There were 300 (18.0%) patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511), medication cost of per day (OR = 1.173), number of medications (OR = 1.140), and age (OR = 0.981) as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription.ConclusionThe prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries.
Highlights
The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan
BMC Geriatrics 2006, 6:1 http://www.biomedcentral.com/1471-2318/6/1 in Japanese long-term care (LTC) facilities which are of three types: long-term care hospitals (LTCHs), health facilities for the elderly (HFEs), and nursing homes (NHs)
In two of the three types of LTC facilities in Japan, LTCHs and HFEs, the cost of medication is included in the per-diem fee, so the medications prescribed are not listed on the claims forms
Summary
The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan. Beers criteria [6,7,8] have been most widely used to estimate prescription of potentially inappropriate medication for nursing home residents, hospital inpatients, and the community-dwelling elderly in the United States, Canada and European countries [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47]. Quality monitoring remains focused on only structural aspects, such as staffing, and there is no formal process of pharmacy reviews
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