Background The prevalence and risk factors of potentially inappropriate medicine use

Background The prevalence and risk factors of potentially inappropriate medicine use among older people patients have already been studied in a variety of countries, but due to the issue of obtaining data on patient characteristics and medicines they never have been studied in Japan. research uncovered that 356 (21.1%) from the sufferers had been treated with potentially incorrect medication separate of disease or condition. One of the most inappropriately medication was ticlopidine typically, which have been recommended for 107 sufferers (6.3%). There have been 300 (18.0%) sufferers treated with in least 1 inappropriate medicine dependent on the condition or condition. The best prevalence of incorrect medication use reliant on the condition or condition was within sufferers with persistent constipation. Multiple logistic regression evaluation revealed psychotropic medication make use of (OR = 1.511), medicine cost of each day 223673-61-8 supplier (OR = 1.173), number of medications (OR = 1.140), and age (OR = 0.981) as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries. Background Inappropriate medication prescription for elderly is usually a major concern because it increases the risk of adverse events and health care costs [1]. Criteria defining inappropriate medication for the elderly CFD1 have been developed in order to decrease its occurrence [2-5]. Beers criteria [6-8] have been most widely used 223673-61-8 supplier to estimate prescription of potentially inappropriate medication for nursing home residents, hospital inpatients, and the community-dwelling elderly in the United States, Canada and European countries [9-47]. However, an extensive literature search did not retrieve any reports on its prevalence in Japanese long-term care (LTC) facilities which are of three types: long-term care hospitals (LTCHs), health facilities for the elderly (HFEs), and nursing homes (NHs). The care-mix among LTCHs, HFEs and NHs overlap, but LTCHs tend to care for the severer medical cases, HFEs for light care cases requiring rehabilitation, and NHs for the stable heavy care cases. There is 24 hour physician and nurse coverage in LTCHs, usually 24 hour nurse coverage but only weekday day-time physician coverage in HFEs, and only weekday work hour nurse coverage in NHs [48,49]. Regarding medications, in two of the three types of LTC facilities in Japan, LTCHs and HFEs, the cost of medication is included in the per-diem fee, so the medications prescribed are not listed on the claims forms. In the third, NHs, medication is usually prescribed by independent physicians and dispensed by 223673-61-8 supplier free-standing pharmacies. Although it is usually theoretically possible to obtain data from the claims forms filed by the pharmacies, it has so far not been possible to link the data with the patient assessment data from the NHs. In all three types of facilities, data on diagnosis and functional status at the patient level are very difficult to obtain because there are neither uniform assessment forms nor any formal mechanisms for data collection. As a result, quality monitoring remains focused on only structural aspects, such as staffing, and there is no formal process of pharmacy reviews. In this study, we focused on the LTC facilities that routinely use the Minimum Data Set (MDS) [50,51] as an assessment instrument for drawing care plans and for monitoring quality. The MDS includes individual patient level information, not only on health or functional status, but also on prescriptions, and has been demonstrated to be highly reliable in the Japanese population [48]. However, the number of LTC facilities that use the MDS are limited, since the form is not mandated in Japan. Therefore, the database we assembled was the only one available for evaluating the prevalence of prescription of potentially inappropriate medication for the elderly in Japanese LTC facilities and analyzing its predictors. Methods Sample This study was conducted in 17 LTC facilities in Japan located throughout the country. We collected the MDS assessment data on 1883 patients aged 65 years and over who were assessed between January and July 2002. Because data on medication prescription for 214 patients were missing, they were excluded. As a result, the database was constructed from the data for the 1669 patients whose data were complete (477 in 8 NHs, 374 in 5 HFEs, and 818 in 4 LTCHs). There were no differences in demographic characteristics (gender, age) between the 1669 subjects of this study and the 214 who were excluded. Data collection The MDS instrument provides individual level data on the following: background information, such as age, gender, 223673-61-8 supplier payment source;.