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KMID : 1170320220280040157
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Korean Journal of Health Economics and Policy
2022 Volume.28 No. 4 p.157 ~ p.203
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Prevalence of potentially inappropriate medication use and its determinants in long-term care facilities: A systematic review
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Jang Su-Hyun
Lee Hee-Won
Jeong Da-Yeon
Jang Sun-Mee
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Abstract
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Older adults living in long-term care facilities (LTCF) are exposed to potentially inappropriate medication (PIM) relatively more than community-dwelling older adults. We aimed to examine the prevalence of PIM and its determinants for LTCF residents through a systematic literature review. Literature searches were performed on January 14, 2022, using the following databases: PubMed, Embase, Cochrane Library, KoeraMed, and RISS. We have included the Beers criteria for the definition of PIM. Two independent reviewers performed the study selection and evaluation of the risk of bias. The risk of bias was evaluated based on the Strength the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The prevalence of PIM was pooled through meta-analysis.
Twenty-nine studies with 227,531 residents were selected and reviewed. The overall prevalence of PIM in LTCF was 66.6% (95% CI 61.1-72.1%), estimated to be 66.1% (95% CI 57.2-75.1%) in studies using Beers 2012(n=12), and 65.2% (95% CI 57.7-72.6%) in studies using Beers 2015(n=16). The primary factor of the increased risk of PIM use was polypharmacy(n=12) in LTCF. Additional determinants were cognitive impairment, dementia, and type of LTCF (private LTCF). Older adults living in LTCF with polypharmacy or cognitive disorder were exposed to a high risk of PIM use, so we need to consider them a priority for medication management in LTCF.
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KEYWORD
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older adults, long-term care facilities, potentially inappropriate medications, determinants, systematic literature r eview, meta-analysis
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