Abstract
Poor sleep quality is prevalent among older adults and is compounded by frailty and polypharmacy. This descriptive, cross-sectional study examines the associations between sleep quality, inappropriate medication use and frailty. The study was conducted among 151 residents of 11 aged care homes in three states in Malaysia; convenience sampling was used. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and Groningen Frailty Indicator (GFI) was used to assess frailty. Medication appropriateness was assessed using Drug burden Index (DBI), Potentially Inappropriate Medications (PIMs) and Potentially Inappropriate Prescriptions (PIPs). Most of the subjects (approximately 95%) reported poor sleep quality, as measured by a cut-off of global PSQI score of ≥ 5. With a second cut-off at 10, just over half (56%) reported moderately poor sleep quality followed by 39% who had very poor sleep quality. Most (90%) denied taking medication to improve their sleep during the previous month. There was no statistically significant association between medication inappropriateness (PIMs, PIPs, DBI) and global PSQI score. However, the average number of PIM was associated significantly with sleep efficiency (a measure of the actual ‘sleep to total time spent in bed) (p = 0.037). The average number of PIP was associated with subjective sleep quality (p = 0.045) and the use of sleep medications (p = 0.001), and inversely associated with sleep disturbance (0.049). Furthermore, frailty correlated significantly with poor overall sleep quality (p = 0.032). Findings support the need for medication review to identify and reduce PIMs and optimise prescriptions to improve sleep quality and hence, related health outcomes among residents of aged care homes.
Highlights
IntroductionInappropriate medication use and frailty the number of persons 80 years is projected to increase almost 7 times [1]
Ageing is an inevitable process which is associated with many health issues
The Beer Criteria for Potentially Inappropriate Medications (PIMs) [4] and Screening Tool of Older Person’s Prescriptions (STOPP) criteria for PIPs [5] refer to the guidelines for healthcare professionals to help improve the safety of prescribing medications for older adults and are based on a medicine-to-avoid list compiled by expert consensus
Summary
Inappropriate medication use and frailty the number of persons 80 years is projected to increase almost 7 times [1]. The trend is reflected in Asia where people aged 60 years as expected to increase from 508 million in 2015 (or 11.6% of the total population) to 1,294 million by 2050 (or 24.6% of the total population) [1]. Chronic and complex multi-morbidities accompany the ageing process, and older people generally require more drugs to treat comorbid conditions. Multiple medical conditions and polypharmacy may increase the risk of adverse drug reactions in older people. Prescribing for older people is a complex process that may lead to the prescribing of Potentially Inappropriate Medications (PIMs) or give rise to Potentially Inappropriate Prescriptions (PIPs) [3]. The Beer Criteria for PIMs [4] and STOPP criteria for PIPs [5] refer to the guidelines for healthcare professionals to help improve the safety of prescribing medications for older adults and are based on a medicine-to-avoid list compiled by expert consensus
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
