Abstract
Objectives
To evaluate the prevalence of medication-related admissions (MRAs) and their association
with potentially inappropriate medications (PIMs) used by nursing home residents admitted
to the geriatric center of a tertiary hospital.
Design
Cross-sectional study.
Setting and Participants
Older patients admitted from nursing homes to the geriatric center of the Seoul National
University Bundang Hospital who had undergone comprehensive geriatric assessment from
January 1, 2016, to December 31, 2020.
Methods
MRAs were determined and verified using a previously described MRA adjudication guide.
The PIMs in the preadmission medication lists were identified according to each of
the following criteria (as well as the combined criteria), the Beers, NORGEP-NH, STOPP/START-NH,
and STOPPFrail criteria. Medication use factors associated with MRAs were analyzed
using multivariate logistic regression.
Results
Among the 304 acute care admissions, 32.2% were MRAs. The main cause of MRAs was acute
kidney injury related with use of renin-angiotensin system inhibitors. Approximately
81% of the patients used at least 1 PIM according to the combined criteria. The use
of 1 or more PIMs, renin-angiotensin system inhibitors, diuretics, nonsteroidal anti-inflammatory
drugs, and benzodiazepines was significantly associated with MRAs. The combined criteria
were able to predict MRAs better than the individual criteria.
Conclusions and Implications
Approximately one-third of acute admissions of nursing home residents may be MRAs.
Interventions for the optimal use of medication among nursing home residents are needed.
Keywords
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Article info
Publication history
Published online: December 16, 2022
Accepted:
November 12,
2022
Received in revised form:
October 15,
2022
Received:
July 5,
2022
Footnotes
This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (grant number 2020R1A2C110097111).
The authors declare no conflicts of interest.
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