TITLE:
Patterns of Medication Use among Romanian Nursing Home Residents
AUTHORS:
Daniela P. Primejdie, Marius T. Bojita, Cornelia Revnic, Adina Popa
KEYWORDS:
Potential Inappropriate Prescribing, Drug-Related Problems, Elderly, Pharmacist, Nursing Home
JOURNAL NAME:
Pharmacology & Pharmacy,
Vol.5 No.6,
June
10,
2014
ABSTRACT: Background: the elderly are frequently exposed to drug-related problems and
their consequences. Information relating to the appropriateness of the
medication used by Romanian elderly is scarce. Objective: to identify the main
potential inappropriate prescribing (PIP) instances in a sample of Romanian
elderly nursing-home residents, concerning prevalence and subtypes.
Methodology: the residents’ medical data were reviewed by a clinical pharmacist
considering published geriatric pharmacotherapy recommendations, including four
published PIP evaluation tools (the Beers criteria, STOPP-START tools, the
PRISCUS list). Results: 91 residents were evaluated; mean age (mean ± SD) was
80.77 ± 6.82 (years), 28 (31%) were ≥85 years old and 58 (64%) had dementia.
The median number of diagnoses was 6 (range 2 - 11) and the mean number (±SD)
of daily medications was 8.26 (±3.52). An estimated mean (±SD) of 2 (±1.41) PIP
per resident was identified, with 117 misuse-PIP (46.24%), 60 underuse-PIP
(23.72%), 41 lack of monitoring-PIP (16.21%) and 35 overuse-PIP (13.83%). The
most frequent PIP subtypes were the use of nonsteroidal anti-inflammatory
drugs as chronic analgesic treatment in osteoarthritis (29.67%), underuse of
fall prevention (100%) and analgesic therapies (23.08%), overuse of nootropic
medications (26.98%) and lack of annual
creatinine assessment (30.77%). Conclusion: a more geriatric-oriented care
seemed to be necessary, but larger studies are needed to confirm these
findings.