Why the study?
Inappropriate polypharmacy increases risk for adverse outcomes and financial burden, but evaluations of objective measures of polypharmacy and their applications in older adults are not well studied.
Polypharmacy is highly prevalent among long-term care residents and medication consumption profiles differ significantly by dementia status and age.
Polypharmacy patterns in long-term care residents with dementia require prospective validation; leaves open causal links to adverse outcomes.
Background Polypharmacy is a significant problem of growing interest in healthcare for older adults with the current increase in drug consumption. Inappropriate polypharmacy is a risk factor for numerous adverse health outcomes and creates a growing financial burden to society. Yet, evaluations of objective measures of polypharmacy and their applications in older adults are not well studied. Here, we investigate the medication use in long‐term care residents and their relationships with age and cognition. Method Medical records including medication consumption of 350 residents in long‐term care facilities (mean age: 81.1 ± 10.9 years; range: 52–104; female: 63.7%) diagnosed with or without dementia (203:147) were reviewed, using PointClickCare and the InterRAI‐MDS2.0. Four scores assessing medication use were generated at two time points (at baseline and at 12 months or at time of discharge). The drug scores included the counts of 1) total medications, 2) prescription drugs, 3) Beers Criteria drugs, and 4) over the counter medications and supplements. Distributions of each the drug scores were examined and their relationships with age and cognition scores (MMSE) were tested using correlation and regression analyses. Group mean scores were compared for dementia status. Result The average number of total drugs, prescription drugs, and beer’s drugs taken were 8.6±4.7 (range: 0‐24), 3.29±5.2 (0‐19), and 1.2±1.2 (0‐6) respectively, and differed by dementia status ( p ‐value<0.050). Each of the drug scores was related with age ( r ’s> 0.0685, p ‐values<0.050). Conclusion Polypharmacy is prevalent in older adults with long‐term care. Residents with dementia have a distinguished profile with medication consumption. Ongoing research in better understanding polypharmacy profiles in relation to frailty and cognition status can further benefit medication optimization of older adults in residential care.
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Zhang et al. (2020) studied this question.
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