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Polypharmacy, potentially inappropriate medication and cognitive status in Austrian nursing home residents: results from the OSiA study

Polypharmazie, potentiell inappropriate Medikamente und kognitiver Status von Bewohnern österreichischer Langzeitpflegeeinrichtungen: Ergebnisse aus der OSiA-Studie

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Summary

There is little research investigating polypharmacy and potentially inappropriate medications (PIM) in connection with cognitive status in residents of Austrian nursing homes. Our findings result from a cross-sectional survey of 425 residents (315 women, 110 men, mean 83.6 years) from 12 Austrian nursing homes. The number of systemically administered permanent prescription drugs was 8.99 ± 3.9 and decreased significantly with increasing cognitive impairment. Irrespective of cognitive status, polypharmacy (> 5 individual substances) was present in approximately 75 % of the residents. Hyper-polypharmacy (> 10 individual substances) was present among almost 50 % of the cognitively intact residents, and hence, significantly more frequent as compared with the group with the lowest cognitive performance (23.4 %). At least one PIM was found in 72.4 % of residents regardless of cognitive status. Predominantly, PIMs consisted of tranquilizers, antipsychotics, osmotic laxatives, non-steroidal anti-inflammatory drugs (NSAIDs) and anticholinergics, where only the number of NSAIDs decreased significantly with increasing cognitive impairment. In summary, our study shows a continued high prevalence of polypharmacy and PIM in long-term care institutions in Austria.

Zusammenfassung

Die Datenlage zu Polypharmazie und potentiell inappropriaten Medikamenten (PIM) bei Bewohnern von österreichischen Langzeitpflegeeinrichtungen in Abhängigkeit vom kognitiven Status ist unzureichend. Unsere Ergebnisse resultieren aus einer Querschnitterhebung von 425 Bewohnern (315 Frauen, 110 Männer, mean 83,6 Jahre) in 12 österreichischen Altenpflegeheimen. Die Zahl der systemisch verabreichten Dauermedikamente betrug 9,0 ± 3,9 und sank mit zunehmender kognitiver Beeinträchtigung signifikant. Polypharmazie (> 5 Einzelsubstanzen) fand sich unabhängig vom kognitiven Status bei etwa 75 % der Bewohner. Hyperpolypharmazie (> 10 Einzelsubstanzen) war mit knapp 50 % bei den kognitiv leistungsfähigeren Bewohnern signifikant häufiger als in der Gruppe mit der geringsten kognitiven Leistungsfähigkeit (23,4 %). Mindestens 1 PIM fand sich bei 72,4 % der Bewohner ohne signifikante Unterschiede in Bezug auf den kognitiven Status. Unter den PIM dominierten Tranquilizer, Antipsychotika, osmotische Laxantien, nicht steroidale Antirheumatika (NSAID) und Anticholinergika., wobei lediglich die Zahl der NSAID mit zunehmender kognitiver Beeinträchtigung signifikant abnahm. Zusammenfassend zeigt unsere Studie eine anhaltend hohe Prävalenz von Polypharmazie und PIM in Einrichtungen der Langzeitpflege in Österreich.

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Authors and Affiliations

  1. Department of Geriatric Medicine, Salzburger Landeskliniken Betriebs-GesmbH, Christian-Doppler-Klinik, Paracelsus Medical University, Ignaz Harrer-Straße 79, 5020, Salzburg, Austria

    Reinhard Alzner MD & Bernhard Iglseder MD

  2. Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria

    Ulrike Bauer MA, Stefan Pitzer MA, Maria Magdalena Schreier & Jürgen Osterbrink PhD

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  1. Reinhard Alzner MD
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  2. Ulrike Bauer MA
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  3. Stefan Pitzer MA
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  4. Maria Magdalena Schreier
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  5. Jürgen Osterbrink PhD
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  6. Bernhard Iglseder MD
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Correspondence to Reinhard Alzner MD.

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R. Alzner, U. Bauer, S. Pitzer, M. M. Schreier, J. Osterbrink, and B. Iglseder declare that there are no actual or potential conflicts of interest in relation to this article.

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Alzner, R., Bauer, U., Pitzer, S. et al. Polypharmacy, potentially inappropriate medication and cognitive status in Austrian nursing home residents: results from the OSiA study. Wien Med Wochenschr 166, 161–165 (2016). https://doi.org/10.1007/s10354-015-0428-8

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  • DOI: https://doi.org/10.1007/s10354-015-0428-8

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