Ann Geriatr Med Res.
2024 Mar;28(1):86-94. 10.4235/agmr.23.0203.
Polypharmacy, Potentially Inappropriate Medications, and Dysphagia in Older Inpatients: A Multi-Center Cohort Study
- Affiliations
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- 1Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako‐shi, Japan
- 2Department of Nursing Care, Sendai Kosei Hospital, Sendai, Japan
- 3Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
- 4Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
- 5Japan Society for the Promotion of Science, Chiyoda, Japan
- 6Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Shinjuku, Japan
- 7Department of Pharmacy, Haradoi Hospital, Fukuoka, Japan
- 8Department of Food and Health, Faculty of Health and Human Development, The University of Nagano, Nagano, Japan
- 9Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
- 10Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, Japan
- KMID: 2553853
- DOI: http://doi.org/10.4235/agmr.23.0203
Abstract
- Background
Although the relationship between medication status, symptomatology, and outcomes has been evaluated, data on the prevalence of polypharmacy and potentially inappropriate medications (PIMs) and the association of polypharmacy and PIMs with swallowing function during follow-up are limited among hospitalized patients aged ≥65 years with dysphagia.
Methods
In this 19‐center cohort study, we registered 467 inpatients aged ≥65 years and evaluated those with the Food Intake LEVEL Scale (FILS) scores ≤8 between November 2019 and March 2021. Polypharmacy was defined as prescribing ≥5 medications and PIMs were identified based on the 2023 Updated Beers Criteria. We applied a generalized linear regression model to examine the association of polypharmacy and PIMs with FILS score at discharge.
Results
We analyzed 399 participants (median age, 83.0 years; males, 49.8%). The median follow‐up was 51.0 days (interquartile range, 22.0–84.0 days). Polypharmacy and PIMs were present in 67.7% of and 56.1% of patients, respectively. After adjusting for covariates, neither polypharmacy (β = 0.05; 95% confidence interval [CI], -0.04–0.13, p=0.30) nor non‐steroidal anti‐inflammatory medications (β = 0.09; 95% CI, -0.02–0.19; p=0.10) were significantly associated with FILS score at discharge.
Conclusions
The results of this study indicated a high proportion of polypharmacy and PIMs among inpatients aged ≥65 years with dysphagia. Although these prescribed conditions were not significantly associated with swallowing function at discharge, our findings suggest the importance of regularly reviewing medications to ensure the appropriateness of prescriptions when managing older inpatients.
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