AED Mono- and Polytherapy among Nursing Home Elderly
Abstract number :
3.160
Submission category :
Year :
2001
Submission ID :
2191
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
S.L. Harms, RPh, MPH, PhD, Health Services Research and Policy, University of Minnesota, Minneapolis, MN; N.A. Hardie, MS, MPH, College of Pharmacy, University of Minnesota, Minneapolis, MN; L.E. Eberly, PhD, Division of Biostatistics, University of Minne
RATIONALE: Nursing home residents are a population historically overburdened with polypharmacy concerns. These issues are accentuated by a changing physiology that may render them more prone to adverse drug events. The purpose of this study was to describe the prevalence and characteristics of antiepileptic drug (AED) polytherapy among nursing home elderly, including determination of which specific AEDs comprise the various therapeutic combinations.
METHODS: This was a cross-sectional, prevalence study of AED use among all nursing home patients [gte] 65 years of age who were present in any one of 531 nursing facilities on July 1, 1999 (N = 58,289). The nursing homes are all owned or operated by Beverly Enterprises, Inc. and the sample covers a 32-state area. Medication data were gathered from physicians[ssquote] orders. Demographic information was collected from each resident[ssquote]s electronic Minimum Data Set records. Data were analyzed by means of logistic regression.
RESULTS: Of the 3318 residents on at least one AED, 224 (6.75%) were on two or more AEDs. One subject was on four AEDs, 15 were on three, and 208 subjects were on two AEDs. Thirty distinct combinations were identified, with phenytoin/phenobarbital as the most common combination, occurring in 51 cases. Using logisitic regression modeling, the contribution of gender, race, educational level, and age as predictor variables was investigated. Age emerged as the only significant variable. Use of AED polytherapy was less in older residents. The odds ratio = 0.62 (CI = 0.51, 0.75) for each 10 year increase in age.
CONCLUSIONS: Use of AED polytherapy in the nursing home is relatively low. While polytherapy is strongly correlated with younger age, none of the other demographic variables (gender, race, educational level) play a significant role. Discussion at the AES conference proceedings will include examination of other predictor variables (comorbidities) and outcome variables (physical and cognitive functional differences).
Support: NIH-NINDS grant [pound]P50-NS16308.