Associations between the Drug Burden Index, Potentially Inappropriate Medications and Quality of Life in Residential Aged Care
Associations between the Drug Burden Index, Potentially Inappropriate Medications and Quality of Life in Residential Aged Care
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DOI：
10.1007/s40266-017-0513-3
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发表时间：
2018-01-01
期刊：
影响因子：
2.8
通讯作者：
Crotty, Maria
中科院分区：
文献类型：
--
作者：
Harrison, Stephanie L.;O'Donnell, Lisa Kouladjian;Crotty, Maria
背景 不适当的多重用药可能会对老年护理机构居民的生活质量产生负面影响，但目前尚不清楚哪些药物可能会影响这种生活质量的下降。 目的 本研究的目的是检查药物负担指数和潜在的不适当药物是否与生活在认知障碍和痴呆症发病率较高的住院护理机构中的老年人的生活质量相关。 方法 我们对澳大利亚 17 个住院老年护理机构中招募的 541 名个体进行了横断面分析，这些人是在《2017 年提供的调查服务》中从澳大利亚 17 个住院老年护理机构中招募的。痴呆症居住环境 (INSPIRED) 研究。使用由参与者或代理人完成的 EuroQol 五维问卷（一般生活质量的衡量标准）和痴呆症生活质量问卷来衡量生活质量。 结果 在招募前 100 天，83.1% 的参与者至少接受了药物负担指数中包含的一种抗胆碱能或镇静药物，73.0% 的参与者根据 Beers 标准接受了至少一种可能不适当的药物。根据 EuroQol 五维问卷 [beta（标准误差）：-0.034 (0.012)，p = 0.006]，在调整潜在的混杂因素后，多水平线性模型显示较高的药物负担指数与较低的生活质量之间存在显着关联。潜在不适当药物数量的增加也与较低的 EuroQol 五维问卷评分 [-0.030 (0.010)，p = 0.003] 和痴呆生活质量问卷自我报告效用评分 [-0.020 (0.009)，p = 0.029] 相关。接触药物负担指数相关药物和潜在不适当药物与较低的痴呆症生活质量问卷自我报告效用评分相关[-0.034 (0.017), p = 0.049]。结论 超过四分之三的住院护理老年人群接触抗胆碱能药物和镇静药物以及潜在不适当药物，并与较低的生活质量相关。
Background Inappropriate polypharmacy may negatively impact the quality of life of residents in aged care facilities, but it remains unclear which medications may influence this reduced quality of life.Objective The objective of this study was to examine whether the Drug Burden Index and potentially inappropriate medications were associated with quality of life in older adults living in residential care with a high prevalence of cognitive impairment and dementia.Methods We conducted cross-sectional analyses of 541 individuals recruited from 17 residential aged care facilities in Australia in the Investigating Services Provided in the Residential Environment for Dementia (INSPIRED) study. Quality of life was measured using the EuroQol Five Dimensions Questionnaire (a measure of generic quality of life) and the Dementia Quality of Life Questionnaire completed by the participant or a proxy.Results In the 100 days prior to recruitment, 83.1% of the participants received at least one anticholinergic or sedative medication included in the Drug Burden Index and 73.0% received at least one potentially inappropriate medication according to the Beers Criteria. Multi-level linear models showed there was a significant association between a higher Drug Burden Index and lower quality of life according to the EuroQol Five Dimensions Questionnaire [beta (standard error): -0.034 (0.012), p = 0.006] after adjustment for potential confounding factors. Increasing numbers of potentially inappropriate medications were also associated with lower EuroQol Five Dimensions Questionnaire scores [-0.030 (0.010), p = 0.003] and Dementia Quality of Life Questionnaire-Self-Report-Utility scores [-0.020 (0.009), p = 0.029]. Exposure to both Drug Burden Index-associated medications and potentially inappropriate medications was associated with lower Dementia Quality of Life Questionnaire-Self-Report-Utility scores [-0.034 (0.017), p = 0.049].Conclusion Exposure to anticholinergic and sedative medications and potentially inappropriate medications occurred in over three-quarters of a population of older adults in residential care and was associated with a lower quality of life.