Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living

Esa YH Chen,1,2 J Simon Bell,1–3 Jenni Ilomaki,2,3 Claire Keen,1 Megan Corlis,2,4 Michelle Hogan,4 Jan Van Emden,2,4 Sarah N Hilmer,2,5 Janet K Sluggett1,2 1Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia; 2N...

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Autores principales:	Chen EYH, Bell JS, Ilomaki J, Keen C, Corlis M, Hogan M, Van Emden J, Hilmer SN, Sluggett JK
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Aged nursing homes medication regimen complexity frailty index activities of daily living multimorbidity long-term care facilities. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/cf6076cb6eda4c0d9c516a9c99c3fced
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spelling	oai:doaj.org-article:cf6076cb6eda4c0d9c516a9c99c3fced2021-12-02T05:59:45ZMedication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living1178-1998https://doaj.org/article/cf6076cb6eda4c0d9c516a9c99c3fced2019-10-01T00:00:00Zhttps://www.dovepress.com/medication-regimen-complexity-in-8-australian-residential-aged-care-fa-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Esa YH Chen,1,2 J Simon Bell,1–3 Jenni Ilomaki,2,3 Claire Keen,1 Megan Corlis,2,4 Michelle Hogan,4 Jan Van Emden,2,4 Sarah N Hilmer,2,5 Janet K Sluggett1,2 1Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia; 2NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia; 3Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia; 4Helping Hand Aged Care, North Adelaide, SA, Australia; 5Kolling Institute, Faculty of Medicine and Health, The University of Sydney and Royal North Shore Hospital, St Leonards, NSW, AustraliaCorrespondence: Esa YH ChenCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, AustraliaTel +61 3 9903 9533Email Esa.Chen@monash.eduObjective: To explore variation in medication regimen complexity in residential aged care facilities (RACFs) according to resident age, length of stay, comorbidity, dementia severity, frailty, and dependence in activities of daily living (ADLs), and compare number of daily administration times and Medication Regimen Complexity Index (MRCI) as measures of regimen complexity.Methods: This study was a cross-sectional analysis of baseline data from the SImplification of Medications Prescribed to Long-tErm care Residents (SIMPLER) cluster-randomized controlled trial. The SIMPLER study recruited 242 residents with at least one medication charted for regular administration from 8 RACFs in South Australia. Comorbidity was assessed using the Charlson Comorbidity Index (CCI). Dementia severity was assessed using the Dementia Severity Rating Scale. Frailty was assessed using the FRAIL-NH scale. Dependence in ADLs was assessed using the Katz ADL scale.Results: The median age of participants was 87 years (interquartile range 81–92). Over one-third of participants (n=86, 36%) had 5 or more daily medication administration times. The number of daily administration times and MRCI scores were positively correlated with resident length of stay (rs=0.19; 0.27), FRAIL-NH score (rs=0.23; 0.34) and dependence in ADLs (rs=−0.21; −0.33) (all p<0.01). MRCI was weakly negatively correlated with CCI score (rs=−0.16; p=0.013). Neither number of daily administration times nor MRCI score were correlated with age or dementia severity. In multivariate analysis, frailty was associated with number of daily administration times (OR: 1.13, 95% CI: 1.03–1.24) and MRCI score (OR: 1.26, 95% CI: 1.13–1.41). Dementia severity was inversely associated with both multiple medication administration times (OR: 0.97, 95% CI: 0.94–0.99) and high MRCI score (OR: 0.95, 95% CI: 0.92–0.98).Conclusion: Residents with longer lengths of stay, more dependent in ADLs and most frail had the most complex medication regimens and, therefore, may benefit from targeted strategies to reduce medication regimen complexity.Keywords: Aged, nursing homes, medication regimen complexity, frailty index, activities of daily living, multimorbidity, long-term care facilitiesChen EYHBell JSIlomaki JKeen CCorlis MHogan MVan Emden JHilmer SNSluggett JKDove Medical PressarticleAgednursing homesmedication regimen complexityfrailty indexactivities of daily livingmultimorbiditylong-term care facilities.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 1783-1795 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Aged nursing homes medication regimen complexity frailty index activities of daily living multimorbidity long-term care facilities. Geriatrics RC952-954.6
spellingShingle	Aged nursing homes medication regimen complexity frailty index activities of daily living multimorbidity long-term care facilities. Geriatrics RC952-954.6 Chen EYH Bell JS Ilomaki J Keen C Corlis M Hogan M Van Emden J Hilmer SN Sluggett JK Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living
description	Esa YH Chen,1,2 J Simon Bell,1–3 Jenni Ilomaki,2,3 Claire Keen,1 Megan Corlis,2,4 Michelle Hogan,4 Jan Van Emden,2,4 Sarah N Hilmer,2,5 Janet K Sluggett1,2 1Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia; 2NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia; 3Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia; 4Helping Hand Aged Care, North Adelaide, SA, Australia; 5Kolling Institute, Faculty of Medicine and Health, The University of Sydney and Royal North Shore Hospital, St Leonards, NSW, AustraliaCorrespondence: Esa YH ChenCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, AustraliaTel +61 3 9903 9533Email Esa.Chen@monash.eduObjective: To explore variation in medication regimen complexity in residential aged care facilities (RACFs) according to resident age, length of stay, comorbidity, dementia severity, frailty, and dependence in activities of daily living (ADLs), and compare number of daily administration times and Medication Regimen Complexity Index (MRCI) as measures of regimen complexity.Methods: This study was a cross-sectional analysis of baseline data from the SImplification of Medications Prescribed to Long-tErm care Residents (SIMPLER) cluster-randomized controlled trial. The SIMPLER study recruited 242 residents with at least one medication charted for regular administration from 8 RACFs in South Australia. Comorbidity was assessed using the Charlson Comorbidity Index (CCI). Dementia severity was assessed using the Dementia Severity Rating Scale. Frailty was assessed using the FRAIL-NH scale. Dependence in ADLs was assessed using the Katz ADL scale.Results: The median age of participants was 87 years (interquartile range 81–92). Over one-third of participants (n=86, 36%) had 5 or more daily medication administration times. The number of daily administration times and MRCI scores were positively correlated with resident length of stay (rs=0.19; 0.27), FRAIL-NH score (rs=0.23; 0.34) and dependence in ADLs (rs=−0.21; −0.33) (all p<0.01). MRCI was weakly negatively correlated with CCI score (rs=−0.16; p=0.013). Neither number of daily administration times nor MRCI score were correlated with age or dementia severity. In multivariate analysis, frailty was associated with number of daily administration times (OR: 1.13, 95% CI: 1.03–1.24) and MRCI score (OR: 1.26, 95% CI: 1.13–1.41). Dementia severity was inversely associated with both multiple medication administration times (OR: 0.97, 95% CI: 0.94–0.99) and high MRCI score (OR: 0.95, 95% CI: 0.92–0.98).Conclusion: Residents with longer lengths of stay, more dependent in ADLs and most frail had the most complex medication regimens and, therefore, may benefit from targeted strategies to reduce medication regimen complexity.Keywords: Aged, nursing homes, medication regimen complexity, frailty index, activities of daily living, multimorbidity, long-term care facilities
format	article
author	Chen EYH Bell JS Ilomaki J Keen C Corlis M Hogan M Van Emden J Hilmer SN Sluggett JK
author_facet	Chen EYH Bell JS Ilomaki J Keen C Corlis M Hogan M Van Emden J Hilmer SN Sluggett JK
author_sort	Chen EYH
title	Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living
title_short	Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living
title_full	Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living
title_fullStr	Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living
title_full_unstemmed	Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living
title_sort	medication regimen complexity in 8 australian residential aged care facilities: impact of age, length of stay, comorbidity, frailty, and dependence in activities of daily living
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/cf6076cb6eda4c0d9c516a9c99c3fced
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Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living

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