Changes in chronic disease medications after admission to a Geriatric Health Services Facility: A multi-center prospective cohort study.

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Tytuł:: Changes in chronic disease medications after admission to a Geriatric Health Services Facility: A multi-center prospective cohort study.
Autorzy:: Maruoka H; Yokohama Aobanosato Geriatric Health Services Facility, Yokohama, Japan.; Division of Social Pharmacy, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan.
Hamada S; Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan.; Department of Home Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.; Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Hattori Y; Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Arai K; Division of Social Pharmacy, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan.; Ooarai Geriatric Health Services Facility, Ibaraki, Japan.
Arimitsu K; Nursing Plaza Kouhoku Geriatric Health Services Facility, Yokohama, Japan.
Higashihara K; Baptist Geriatric Health Services Facility, Kyoto, Japan.
Saotome S; Onahama Tokiwaen Geriatric Health Services Facility, Fukushima, Japan.
Kobayashi A; Rehabilitation Port Yokohama Geriatric Health Services Facility, Yokohama, Japan.
Watanabe N; Yokohama Aobanosato Geriatric Health Services Facility, Yokohama, Japan.
Kurata N; Division of Social Pharmacy, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan.
Kishimoto K; Division of Social Pharmacy, Department of Healthcare and Regulatory Sciences, School of Pharmacy, Showa University, Tokyo, Japan.
Kojima T; Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Źródło:: Medicine [Medicine (Baltimore)] 2023 May 26; Vol. 102 (21), pp. e33552.
Typ publikacji:: Multicenter Study; Journal Article
Język:: English
Imprint Name(s):: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
MeSH Terms:: Health Services for the Aged*
Hypertension*/drug therapy
Aged ; Humans ; Female ; Male ; Prospective Studies ; Nursing Homes ; Lipids ; Polypharmacy
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Substance Nomenclature:: 0 (Lipids)
Entry Date(s):: Date Created: 20230526 Date Completed: 20230529 Latest Revision: 20230916
Update Code:: 20240105
PubMed Central ID:: PMC10219748
DOI:: 10.1097/MD.0000000000033552
PMID:: 37233437
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Older adults often receive polypharmacy, including some medications for chronic diseases. Nutritional management after admission to a nursing home may enable to deprescribe some chronic disease medications. This study aimed to investigate the status of deprescribing of chronic disease medications among nursing home residents, and to assess the appropriateness based on changes of laboratory test values and nutritional status. A multi-center prospective cohort study was conducted in 6 Geriatric Health Services Facilities, a major type of nursing homes in Japan. Newly admitted residents aged ≥ 65 years who took ≥1 medication for hypertension, diabetes, or dyslipidemia at admission were recruited. Participants who stayed for 3 months were included in the analysis. Medications at admission and 3 months after admission and situations for deprescribing were investigated. Changes in body mass index, blood pressure, laboratory tests (e.g., cholesterol and hemoglobin A1c levels), energy intake, and International Classification of Functioning, Disability and Health staging were evaluated. Sixty-nine participants (68% female, 62% aged ≥ 85 years) were included. At admission, 60 participants had medications for hypertension, 29 for dyslipidemia, and 13 for diabetes. Those receiving lipid-modifying drugs (mainly statins) decreased from 29 to 21 (72%; P = .008), since their cholesterol levels was within the normal range or was low at admission, and they had no history of cardiovascular events. However, there were no statistically significant changes in the frequencies of antihypertensive drugs (60 to 55; 92%; P = .063) or antidiabetic drugs (13 to 12; 92%; P = 1.000). During the 3-month observation, body mass index and diastolic blood pressure decreased, while energy intake and serum albumin level increased. Nutritional management after admission to a ROKEN may facilitate appropriate deprescribing of lipid-modifying drugs, by offseting the effects of discontinuation of these drugs.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

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