Evidence mapPaperPMID 38833339Full record

ArticleAnnals of medicine2024

Polypharmacy and potentially inappropriate prescribing of benzodiazepines in older nursing home residents.

Ingrid Kummer, Jindra Reissigová, Anna Lukačišinová, Maja Ortner Hadžiabdić, Matej Stuhec, Rosa Liperoti, Harriet Finne-Soveri, Graziano Onder, Hein van Hout, Daniela Fialová

Abstract read
In one paragraph

Article in Annals of medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Observational
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  5. Observational
  6. Article
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  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ingrid KummerDepartment of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, The Czech Republic.ORCID 0000-0003-0205-1576
Jindra ReissigováDepartment of Statistical Modelling, Institute of Computer Science of the Czech Academy of Sciences, Prague, The Czech Republic.ORCID 0000-0002-5402-699X
Anna LukačišinováDepartment of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, The Czech Republic.ORCID 0000-0001-6461-5977
Maja Ortner HadžiabdićCenter for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia.ORCID 0000-0003-1578-9764
Matej StuhecDepartment of Pharmacology, Faculty of Medicine Maribor, University of Maribor, Maribor, Slovenia.ORCID 0000-0001-5909-6930
Rosa LiperotiFondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Harriet Finne-SoveriNational Institute for Health and Welfare, Helsinki, Finland.ORCID 0000-0001-8836-1860
Graziano OnderFondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.ORCID 0000-0003-3400-4491
Hein van HoutDepartments of General Practice and Medicine for Older People, Amsterdam University Medical Center, location Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.ORCID 0000-0002-2495-4808
Daniela FialováDepartment of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, The Czech Republic.ORCID 0000-0001-5638-9690

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPrevious research has raised concerns about high prevalence of drug-related problems, polypharmacy and inappropriate benzodiazepine prescribing in nursing homes (NHs) and confirmed lack of studies from Central and South-Eastern Europe. The aim of our study was to determine the prevalence and characteristics of polypharmacy, hyperpolypharmacy and inappropriate benzodiazepine prescribing in NH residents in Croatia.

methodsData from 226 older NH residents from five Croatian NHs were collected using the InterRAI Long-Term Care Facilities assessment form. The prevalence and determinants of polypharmacy/hyperpolypharmacy and patterns of inappropriate benzodiazepine prescribing were documented.

resultsThe prevalence of polypharmacy (49.6%) and hyperpolypharmacy (25.7%) among NH residents was high. In our study, 72.1% of NH residents were prescribed at least one psychotropic agent, 36.7% used 2-3 psychotropics and 6.6% used 4+ psychotropics. Among benzodiazepine users (55.8%), 28% of residents were prescribed benzodiazepines in higher than recommended geriatric doses, 75% used them for the long term and 48% were prescribed concomitant interacting medications. The odds of being prescribed polypharmacy/hyperpolypharmacy were significantly higher for older patients with polymorbidity (6+ disorders, proportional odds ratio (POR) = 19.8), type II diabetes (POR = 5.2), ischemic heart disease (POR = 4.6), higher frailty (Clinical Frailty Scale (CFS ≥5); POR = 4.3) and gastrointestinal problems (POR = 4.8).

conclusionsOur research underscores the persistent challenge of inappropriate medication use and drug-related harms among older NH residents, despite existing evidence and professional campaigns. Effective regulatory and policy interventions, including the implementation of geriatrician and clinical pharmacy services, are essential to address this critical issue and ensure optimal medication management for vulnerable NH populations.

Indexed as

BenzodiazepinesInappropriate PrescribingNursing HomesPolypharmacyAgedAged, 80 and overCroatiaFemaleHomes for the AgedHumansMalePractice Patterns, Physicians'PrevalencePsychotropic DrugsBenzodiazepinesPsychotropic Drugsgeriatric deprescribinginappropriate benzodiazepine prescribingNursing home residentspolypharmacy/hyperpolypharmacypsychiatric polypharmacy/hyperpolypharmacy

Identifiers

PMID38833339
PMCPMC11151799

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.