Potentially inappropriate prescribing before and after nursing home admission: a retrospective observational study in a sample of Italian nursing homes.

Ettore Marconi, Giada Crescioli, Roberto Bonaiuti, Chiara Lorini, Francesca Collini, Pasquale Pepe, Ersilia Lucenteforte, Maria Chiara Cavallini, Mauro Di Bari, Guglielmo Bonaccorsi, Alfredo Vannacci, Niccolò Lombardi

Journal: Epidemiologia e prevenzione 2022;46(4):268-272

PMID: 36259343

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Abstract

OBJECTIVES

to assess the occurrence of potentially inappropriate prescribing (PIP) in residents of Tuscany nursing homes (NHs) and its variation before and after NH entry.

DESIGN

retrospective observational study using data from the Regional Administrative Database of Tuscany.

SETTING AND PARTICIPANTS

the study involved residents of 67 Tuscan NHs identified between 2011 and 2012. To estimate PIP prevalence before and after NH, a subset of 10 indicators of the Screening Tool of Older Person's Prescriptions (STOPP) criteria were selected.

MAIN OUTCOME MEASURES

prevalence of PIP. RESULTS: considering 2,801 NH residents, the proportion of PIP ranged from 0.0% to 55.2% and from 0.0% to 33.9% before and after the NH admission, respectively. Overall, this study showed a decrease in the occurrence of PIP after the NH admission for most of the indicators, reaching statistical significance for indicator 3 (tricyclic antidepressants in combination with an opiate or calcium channel blockers), 7 (prescription of NSAIDs in heart failure patients), and 9 (warfarin in combination with NSAIDs).

CONCLUSIONS

although the reduction of PIP after NH admission may suggest greater awareness about the appropriateness of drug use, more efforts still need to be made.

Address: Health Search, Italian College of General Practitioners and Primary Care, Florence (Italy).; These authors equally contributed to the article.; Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence (Italy).; Tuscan Regional Centre of Pharmacovigilance, Florence (Italy).; Department of Health Science, University of Florence, Florence (Italy).; Quality and Equity Unit, Regional Health Agency of Tuscany, Florence (Italy).; Department of Clinical and Experimental Medicine, University of Pisa, Pisa (Italy).; Geriatric Intensive Care Medicine, Careggi University Hospital, Florence (Italy).; Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence (Italy); [email protected].

DOI: 10.19191/EP22.4.A372.075

MeSH Terms: Humans, Aged, Inappropriate Prescribing, Calcium Channel Blockers, Antidepressive Agents, Tricyclic, Warfarin, Italy, Nursing Homes, Opiate Alkaloids, Anti-Inflammatory Agents, Non-Steroidal