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Tytuł pozycji:

Mortality, hospitalisation, institutionalisation in community-dwelling oldest old: The impact of medication.

Tytuł :
Mortality, hospitalisation, institutionalisation in community-dwelling oldest old: The impact of medication.
Autorzy :
Wauters M; Ghent University, Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent, Belgium. Electronic address: .
Elseviers M; Ghent University, Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent, Belgium.
Vaes B; Université catholique de Louvain, Louvain Drug Research Institute, Cliniques universitaires Saint-luc, Brussels, Belgium; Catholic University of Leuven, Department of Public and Primary Health Care, Leuven, Belgium.
Degryse J; Université catholique de Louvain, Louvain Drug Research Institute, Cliniques universitaires Saint-luc, Brussels, Belgium; Catholic University of Leuven, Department of Public and Primary Health Care, Leuven, Belgium.
Vander Stichele R; Ghent University, Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent, Belgium.
Christiaens T; Ghent University, Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent, Belgium.
Azermai M; Ghent University, Heymans Institute of Pharmacology, Clinical Pharmacology Research Unit, Ghent, Belgium.
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Źródło :
Archives of gerontology and geriatrics [Arch Gerontol Geriatr] 2016 Jul-Aug; Vol. 65, pp. 9-16. Date of Electronic Publication: 2016 Feb 16.
Typ publikacji :
Journal Article; Observational Study
Język :
English
Imprint Name(s) :
Original Publication: Amsterdam : Elsevier Biomedical Press, c1982-
MeSH Terms :
Aged, 80 and over*
Mortality*
Polypharmacy*
Hospitalization/*statistics & numerical data
Nursing Homes/*statistics & numerical data
Belgium/epidemiology ; Female ; Humans ; Male ; Prospective Studies
Contributed Indexing :
Keywords: Aged, 80 and over*; Drug utilization*; Hospitalization*; Institutionalization*; Mortality*; Primary health care*
Entry Date(s) :
Date Created: 20160226 Date Completed: 20170707 Latest Revision: 20190318
Update Code :
20210914
DOI :
10.1016/j.archger.2016.02.009
PMID :
26913791
Czasopismo naukowe
Background: High drug use and associated adverse outcomes are common in older adults. This study investigates association of medication use with mortality, hospitalisation, and institutionalisation in a cohort of community-dwelling oldest old (aged 80 and over).
Methods: Baseline data included socio-demographic, clinical, and functional characteristics, and prescribed medications. Medications were coded by the Anatomic Therapeutic Chemical classification. Survival analysis was performed at 18 months after inclusion using Kaplan-Meier, and multivariate analysis with Cox regression to control for covariates.
Results: Patients' (n=503) mean age was 84.4 years (range 80-102), and 61.2% was female. The median medication use was 5 (0-16). The mortality, hospitalisation, and institutionalisation rate were 8.9%, 31.0%, and 6.4% respectively. The mortality and hospitalisation group had a higher level of multimorbidity and weaker functional profile. Adjusted multivariate models showed an 11% increased hospitalisation rate for every additional medication taken. No association was found between high medication use and mortality, nor with institutionalisation. A higher association for mortality was observed among verapamil/diltiazem users, hospitalisation was higher among users of verapamil/diltiazem, loop diuretics and respiratory agents. Institutionalisation was higher among benzodiazepines users.
Conclusion: In the community-dwelling oldest old (aged 80 and over), high medication was clearly associated with hospitalisation, independent of multimorbidity. The association with mortality was clear in univariate, but not in multivariate analysis. No association with institutionalisation was found. The appropriateness of the high medication use should be further studied in relation to mortality, hospitalisation, and institutionalisation for this specific age group.
(Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

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