PMID- 28927372 OWN - NLM STAT- MEDLINE DCOM- 20180410 LR - 20220408 IS - 1471-2318 (Electronic) IS - 1471-2318 (Linking) VI - 17 IP - 1 DP - 2017 Sep 19 TI - Potentially inappropriate medication use in nursing homes: an observational study using the NORGEP-NH criteria. PG - 220 LID - 10.1186/s12877-017-0608-z [doi] LID - 220 AB - BACKGROUND: Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors. METHODS: Cross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway. Data collected 2009-11 included residents' demographic and clinical status and all medications, regular and on demand. RESULTS: 881 patients from 30 institutions (mean 85.9 years, 68.6% female), were included. According to NORGEP-NH, 43.8% were prescribed at least one potentially inappropriate regular medication, and 9.9% regularly received three or more potentially inappropriate medications. When also including a) the NORGEP-NH Deprescribing Criteria and b) including drugs prescribed for use as needed, 92.7% of all residents received medication that needs particular surveillance according to the NORGEP-NH. 69.7% of the nursing home residents used at least one psychotropic drug regularly. Female residents received more often than males at least one potentially inappropriate regular medication (OR 1.60, p=0.007). Regarding the prescription of three or more concomitant psychotropic medications, odds ratio for females was 1.79 (p=0.03) compared to males. Residents with the best performance in activities of daily living, and residents residing in long-term wards, had higher risk of using three or more psychotropic drugs. Use of multiple psychoactive drugs increased the risk of falls in the course of an acute episode of infection or dehydration (odds ratio 1.70, p=0.009). CONCLUSIONS: Prevalence of potentially inappropriate medications in nursing homes according to the NORGEP-NH was extensive, and especially the use of multiple psychotropic drugs. The high prevalence found in this study shows that there is a need for higher awareness of medication use and side effects in the elderly population. TRIAL REGISTRATION: Retrospectively registered. Data obtained from clinical trial NCT01023763 registered with ClinicalTrials.gov 12/01/2009. FAU - Nyborg, Gunhild AU - Nyborg G AUID- ORCID: 0000-0001-8098-5169 AD - Department of General Practice/Family Medicine, HELSAM, Institute of Health and Society, University of Oslo, P.o. Box 1130 Blindern, 0318, Oslo, Norway. gunhild.nyborg@medisin.uio.no. FAU - Brekke, Mette AU - Brekke M AD - Department of General Practice/Family Medicine, HELSAM, Institute of Health and Society, University of Oslo, P.o. Box 1130 Blindern, 0318, Oslo, Norway. FAU - Straand, Jorund AU - Straand J AD - Department of General Practice/Family Medicine, HELSAM, Institute of Health and Society, University of Oslo, P.o. Box 1130 Blindern, 0318, Oslo, Norway. FAU - Gjelstad, Svein AU - Gjelstad S AD - Department of General Practice/Family Medicine, HELSAM, Institute of Health and Society, University of Oslo, P.o. Box 1130 Blindern, 0318, Oslo, Norway. FAU - Romoren, Maria AU - Romoren M AD - Department of General Practice/Family Medicine, HELSAM, Institute of Health and Society, University of Oslo, P.o. Box 1130 Blindern, 0318, Oslo, Norway. LA - eng SI - ClinicalTrials.gov/NCT01023763 PT - Clinical Trial PT - Journal Article PT - Observational Study DEP - 20170919 PL - England TA - BMC Geriatr JT - BMC geriatrics JID - 100968548 RN - 0 (Psychotropic Drugs) SB - IM MH - Aged MH - Aged, 80 and over MH - Cross-Sectional Studies MH - Female MH - Homes for the Aged/*statistics & numerical data MH - Humans MH - Inappropriate Prescribing/*statistics & numerical data MH - Male MH - Medication Errors/*prevention & control MH - Norway/epidemiology MH - Nursing Homes/*statistics & numerical data MH - Pharmacoepidemiology/statistics & numerical data MH - Potentially Inappropriate Medication List/*statistics & numerical data MH - Prevalence MH - Psychotropic Drugs/adverse effects MH - Retrospective Studies PMC - PMC5606129 OTO - NOTNLM OT - Drug safety OT - Elderly OT - Explicit criteria OT - NORGEP-NH OT - Nursing homes OT - Potentially inappropriate medication use OT - Psychotropic medications COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study was approved by the Regional Committee for Medical and Health Research Ethics (REK) (reference no. 2009/1584a-1). Written informed consent was obtained from all patients. In patients lacking decision-making capacity, written consent was collected from next of kin. The 3iV study is reported in accordance with the Consort 2010 extension to cluster randomised trials and the suggested modifications to the Consort 2010 cluster extension for reporting of stepped wedge cluster randomised trials [27, 82]. Trial registration with ClinicalTrials.gov: NCT01023763. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2017/09/21 06:00 MHDA- 2018/04/11 06:00 PMCR- 2017/09/19 CRDT- 2017/09/21 06:00 PHST- 2017/01/25 00:00 [received] PHST- 2017/09/06 00:00 [accepted] PHST- 2017/09/21 06:00 [entrez] PHST- 2017/09/21 06:00 [pubmed] PHST- 2018/04/11 06:00 [medline] PHST- 2017/09/19 00:00 [pmc-release] AID - 10.1186/s12877-017-0608-z [pii] AID - 608 [pii] AID - 10.1186/s12877-017-0608-z [doi] PST - epublish SO - BMC Geriatr. 2017 Sep 19;17(1):220. doi: 10.1186/s12877-017-0608-z.