449 - How much frequency do residents fall at nursing homes in Japan ? - THE JADE STUDY.
449 - How much frequency do residents fall at nursing homes in Japan ? - THE JADE STUDY.
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449 - 日本疗养院的居民跌倒的频率有多少？
DOI：
10.1017/s1041610220003014
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发表时间：
2020
影响因子：
7
通讯作者：
Jin Narumoto
中科院分区：
文献类型：
--
作者：
Nozomu Oya;Nobutaka Ayani;Akiko Kuwahara;Riki Kitaoka;Chie Omichi;Mio Sakuma;Takeshi Morimoto;Jin Narumoto
日本迅速成为老龄化社会，2018年日本65岁以上人口的比例约为28.1%（约3600万人）。然后，住在养老院的人数也在增加。许多养老院的居民正在接受药物治疗，与药物有关的跌倒是该机构的一个主要问题。药物导致的跌倒有时会发生并导致严重的后果。然后，本研究的目的是确定跌倒的发生率及其与药物的关系。方法日本养老院不良药物事件（JADE）研究为一系列队列研究。养老院JADE研究是一项前瞻性队列研究，在日本4家养老院进行。根据经过验证的方法，训练有素的心理学家和医生审查了所有图表，以确定ade（药物不良事件，药物引起的伤害），怀疑与药物有关。同时，我们收集了所有与药物无关的跌落。在收集这些事件后，4名医生独立地进行了第二次审查。本研究已获得京都立医科大学机构审查委员会的批准。结果共入组居民459人，累计观察时间3315个月。平均（SD）年龄为85.8(7)岁，女性344例（75%）。在研究期间，我们发现196名居民（39.6%）发生655次跌倒（发病率：16.9 / 100个居民月）。166例居民中有568例跌倒（86.7%）与ADEs有关。其中10.9%（62/568）患者伴有损伤，2.6%（15/568）患者发生骨折。与跌倒相关的最常见药物是苯二氮卓类催眠药（23.2%,132/568）和非典型抗精神病药（17.4%,99/568）。结论日本养老院的跌倒频率与其他国家相当（L. Z, Rubenstein, 1996）。由于其中很大一部分与药物有关，因此需要仔细监测药物。
IntroductionJapan has become an aging society rapidly, and the percentage of the population over 65 was about 28.1% (around 36 million people) in 2018 in Japan. Then, the number of residents in nursing home has been also increasing.Many residents in nursing home are receiving pharmacotherapy, and drug-related falls are a major problem at the institution. Fall due to medication sometimes occurs and results in serious consequences.Then, the aim of this study was to identify the incidence of falls and its association with medication.MethodThe Japan Adverse Drug Event (JADE) study for nursing home is a series of cohort studies. The JADE study for nursing home is a prospective cohort study that was conducted at 4 nursing home for elder people in Japan.Based on the validated methodology, trained psychologists, medical doctors reviewed all charts to identify ADEs (Adverse Drug Events, injuries due to medication), suspected to being associated with medication. Simultaneously, we collected all falls regardless of drug association.After collecting these events, 4 medical doctors independently made a secondary review. This study was approved by the institutional review boards of the Kyoto Prefectural University of Medicine.ResultWe enrolled 459 residents, which yielded 3315 resident-months of observation time. The mean (SD) age was 85.8 (7) years and 344 (75%) were female. We identified 655 falls in 196 residents (39.6%) during the study period (incidence: 16.9 per 100 resident-months). 568 falls (86.7%) in 166 residents were related to ADEs. Among them, 10.9% (62/568) were accompanied by injuries, and 2.6% (15/568) of them resulted in fracture. The most common class of drugs associated with falls was benzodiazepine hypnotics (23.2%, 132/568) and atypical antipsychotics (17.4%, 99/568).ConclusionThe frequency of falls in nursing homes in Japan was comparable to other countries (L. Z, Rubenstein, 1996). Since significant portion of them were associated with medication, careful monitoring of medication is required.