Inappropriate Drug Prescribing and Polypharmacy Are Major Causes of Poor Outcomes in Long-Term Care

John E. Morley

doi:10.1016/j.jamda.2014.09.003

Editorial| Volume 15, ISSUE 11, P780-782, November 2014

Inappropriate Drug Prescribing and Polypharmacy Are Major Causes of Poor Outcomes in Long-Term Care

John E. Morley, MB, BCh
John E. Morley
Correspondence
Address correspondence to John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Boulevard, M238, St Louis, MO 63104.
Contact
Affiliations
Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St Louis, MO
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DOI:https://doi.org/10.1016/j.jamda.2014.09.003

Previously in your Journal, we have stressed the problems associated with medications in long-term care.

¹

Onder G.
Liperoti R.
Foebel A.
et al.

Polypharmacy and mortality among nursing home residents with advanced cognitive impairment: Results from the SHELTER study.

^,

²

Little M.O.
Morley A.

Reducing polypharmacy: Evidence from a simple quality improvement initiative.

^,

³

de Souto Barreto P.
Lapeyre-Mestre M.
Mathieu C.
et al.

Prevalence and associations of the use of proton-pump inhibitors in nursing homes: A cross-sectional study.

^,

⁴

Cestac P.
Tavassoli N.
Vellas B.
Rolland Y.

Improving medication use in the nursing homes: A European perspective.

^,

⁵

De Souto Barreto P.
Lapeyre-Mestre M.
Mathieu C.
et al.

Indicators of benzodiazepine use in nursing home residents in France: A cross-sectional study.

^,

⁶

Kojima G.
Bell C.
Tamura B.
et al.

Reducing cost by reducing polypharmacy: The polypharmacy outcomes project.

^,

⁷

Bronskill S.E.
Gill S.S.
Paterson J.M.
et al.

Exploring variation in rates of polypharmacy across long term care homes.

^,

⁸

Tamura B.K.
Cl Bell
Lubimir K.
et al.

Physician intervention for medication reduction in a nursing home: The polypharmacy outcomes projects.

^,

⁹

Fitzgerald S.P.
Bean N.G.

An analysis of the interactions between individual comorbidities and their treatments—implications for guidelines and polypharmacy.

^,

¹⁰

Gokce Kutsal Y.
Barak A.
Atalay A.
et al.

Polypharmacy in the elderly: A multicenter study.

^,

¹¹

Morley J.E.

Polypharmacy in the nursing home.

^,

¹²

Levenson S.A.
Saffel D.A.

The consultant pharmacist and the physician in the nursing home: Roles, relationships, and a recipe for success.

In this issue, we have 6 further articles stressing the problems of inappropriate prescribing and providing some solutions to control medication usage in the nursing home.

¹³

Cool C.

Potentially inappropriate drug prescribing and associated factors in nursing homes.

^,

¹⁴

Landi F.

Anticholinergic drugs use and negative outcomes among frail elderly population living in nursing home.

^,

¹⁵

Hein C.
Forgues A.
Piau A.
et al.

Impact of polypharmacy on occurrence in elderly emergency patients.

^,

¹⁶

Grace A.
Briggs R.
Kieran R.E.
et al.

A comparison of Beers and STOPP criteria in assessing potentially inappropriate medications in nursing home residents attending the emergency department.

^,

¹⁷

Ward K.
Eslami M.
Garcia M.
McCreath H.

Do internal medicine residents know enough about skilled nursing facilities to orchestrate a good care transition?.

^,

¹⁸

Smeets C.
Smalbrugge M.
Zuidema S.
et al.

Factors related to psychotropic drug prescription for neuropsychiatric symptoms in nursing home residents with dementia.

Inappropriate medications are a major reason for readmission to hospital from long-term care.

¹⁹

Morandi A.
Bellelli G.
Vasilevskis E.E.
et al.

Predictors of rehospitalization among elderly patients admitted to a rehabilitation hospital: The role of polypharmacy, functional status, and length of stay.

^,

²⁰

Ouslander J.G.
Perloe M.
Givens J.H.
et al.

Reducing potentially avoidable hospitalizations of nursing home residents: Results of a pilot quality improvement project.

^,

²¹

Tena-Nelson R.
Santos K.
Weingast E.
et al.

Reducing potentially preventable hospital transfers: Results from a thirty nursing home collaborative.

^,

²²

Ouslander J.G.
Bonner A.
Herndon L.
Shutes J.

The interventions to reduce acute care transfers (INTERACT) quality improvement program: An overview for medical directors and primary care clinicians in long term care.

^,

²³

Little M.O.

Climbing out of the black hole of subacute care.

^,

²⁴

Morley J.E.
Caplan G.
Cesari M.
et al.

International survey of nursing home research priorities.

^,

²⁵

Aaltonen M.
Raitanen J.
Forma L.
et al.

Burdensome transitions at the end of life among long-term care residents with dementia.

^,

²⁶

Rolland Y.
Resnick B.
Katz P.R.
et al.

Nursing home research: The first International Association of Gerontology and Geriatrics (IAGG) research conference.

^,

²⁷

Berkowitz R.E.
Fang Z.
Helfand B.K.
et al.

Project ReEngineered Discharge (RED) lowers hospital readmissions of patients discharged from a skilled nursing facility.

^,

²⁸

Gruneir A.
Bronskill S.
Bell C.
et al.

Recent health care transitions and emergency department use by chronic long term care residents: A population-based cohort study.

^,

²⁹

Gruneir A.
Anderson G.M.
Rochon P.A.
Bronskill S.

Transitions in long-term care and potential implications for quality reporting in Ontario, Canada.

^,

³⁰

Morley J.E.

Transitions.

This is spurred by the ridiculous medications that many patients are started on in the hospital by physicians who have no concept of how to manage the frail elderly.

³¹

Morley J.E.
Vellas B.
van Kan G.A.
et al.

Frailty consensus: A call to action.

^,

³²

Morley J.E.

Frailty, falls, and fractures.

^,

³³

Morley J.E.
Malmstrom T.K.
Miller D.K.

A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans.

^,

³⁴

Morley J.E.

Frailty screening comes of age.

^,

³⁵

Morley J.E.
von Haehling S.
Anker S.D.
Vellas B.

From sarcopenia to frailty: A road less traveled.

^,

³⁶

Morley J.E.

Frailty: Diagnosis and management.

^,

³⁷

Morley J.E.

Developing novel therapeutic approaches to frailty.

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- Liperoti R.
- Foebel A.
- et al.
Polypharmacy and mortality among nursing home residents with advanced cognitive impairment: Results from the SHELTER study.
J Am Med Dir Assoc. 2013; 14: 450.e7-450.e12
View in Article
- Little M.O.
- Morley A.
Reducing polypharmacy: Evidence from a simple quality improvement initiative.
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View in Article
- de Souto Barreto P.
- Lapeyre-Mestre M.
- Mathieu C.
- et al.
Prevalence and associations of the use of proton-pump inhibitors in nursing homes: A cross-sectional study.
J Am Med Dir Assoc. 2013; 14: 265-269
View in Article
- Cestac P.
- Tavassoli N.
- Vellas B.
- Rolland Y.
Improving medication use in the nursing homes: A European perspective.
J Am Med Dir Assoc. 2013; 14: 6-9
View in Article
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- Lapeyre-Mestre M.
- Mathieu C.
- et al.
Indicators of benzodiazepine use in nursing home residents in France: A cross-sectional study.
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View in Article
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- Bell C.
- Tamura B.
- et al.
Reducing cost by reducing polypharmacy: The polypharmacy outcomes project.
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View in Article
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- Gill S.S.
- Paterson J.M.
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Exploring variation in rates of polypharmacy across long term care homes.
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- Lubimir K.
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Physician intervention for medication reduction in a nursing home: The polypharmacy outcomes projects.
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An analysis of the interactions between individual comorbidities and their treatments—implications for guidelines and polypharmacy.
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Polypharmacy in the elderly: A multicenter study.
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Polypharmacy in the nursing home.
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The consultant pharmacist and the physician in the nursing home: Roles, relationships, and a recipe for success.
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Potentially inappropriate drug prescribing and associated factors in nursing homes.
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Anticholinergic drugs use and negative outcomes among frail elderly population living in nursing home.
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Impact of polypharmacy on occurrence in elderly emergency patients.
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- Kieran R.E.
- et al.
A comparison of Beers and STOPP criteria in assessing potentially inappropriate medications in nursing home residents attending the emergency department.
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View in Article
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- Eslami M.
- Garcia M.
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Do internal medicine residents know enough about skilled nursing facilities to orchestrate a good care transition?.
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View in Article
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- Smalbrugge M.
- Zuidema S.
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Factors related to psychotropic drug prescription for neuropsychiatric symptoms in nursing home residents with dementia.
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View in Article
- Morandi A.
- Bellelli G.
- Vasilevskis E.E.
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Predictors of rehospitalization among elderly patients admitted to a rehabilitation hospital: The role of polypharmacy, functional status, and length of stay.
J Am Med Dir Assoc. 2013; 14: 761-767
View in Article
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Reducing potentially avoidable hospitalizations of nursing home residents: Results of a pilot quality improvement project.
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View in Article
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- Santos K.
- Weingast E.
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Reducing potentially preventable hospital transfers: Results from a thirty nursing home collaborative.
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View in Article
- Ouslander J.G.
- Bonner A.
- Herndon L.
- Shutes J.
The interventions to reduce acute care transfers (INTERACT) quality improvement program: An overview for medical directors and primary care clinicians in long term care.
J Am Med Dir Assoc. 2014; 15: 162-170
View in Article
- Little M.O.
Climbing out of the black hole of subacute care.
J Am Med Dir Assoc. 2012; 13: 493-494
View in Article
- Morley J.E.
- Caplan G.
- Cesari M.
- et al.
International survey of nursing home research priorities.
J Am Med Dir Assoc. 2014; 15: 309-312
View in Article
- Aaltonen M.
- Raitanen J.
- Forma L.
- et al.
Burdensome transitions at the end of life among long-term care residents with dementia.
J Am Med Dir Assoc. 2014; 15: 643-648
View in Article
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- et al.
Nursing home research: The first International Association of Gerontology and Geriatrics (IAGG) research conference.
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View in Article
- Berkowitz R.E.
- Fang Z.
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Project ReEngineered Discharge (RED) lowers hospital readmissions of patients discharged from a skilled nursing facility.
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View in Article
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Recent health care transitions and emergency department use by chronic long term care residents: A population-based cohort study.
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Transitions in long-term care and potential implications for quality reporting in Ontario, Canada.
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Frailty consensus: A call to action.
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Frailty, falls, and fractures.
J Am Med Dir Assoc. 2013; 14: 149-151
View in Article
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A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans.
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Frailty screening comes of age.
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Frailty: Diagnosis and management.
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Inappropriate Drug Prescribing and Polypharmacy Are Major Causes of Poor Outcomes in Long-Term Care

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