Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims data
BACKGROUND To date, comprehensive data on drug utilisation in Swiss nursing homes are lacking. OBJECTIVE To describe drug prescription patterns, polypharmacy and potentially inappropriate medication (PIM) in Swiss nursing home residents (NHR)....
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2019-09-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2674 |
| _version_ | 1811194339038068736 |
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| author | Rahel Schneider Daphne Reinau Nadine Schur Eva Blozik Mathias Früh Andri Signorell Christoph R. Meier Matthias Schwenkglenks |
| author_facet | Rahel Schneider Daphne Reinau Nadine Schur Eva Blozik Mathias Früh Andri Signorell Christoph R. Meier Matthias Schwenkglenks |
| author_sort | Rahel Schneider |
| collection | DOAJ |
| description |
BACKGROUND
To date, comprehensive data on drug utilisation in Swiss nursing homes are lacking.
OBJECTIVE
To describe drug prescription patterns, polypharmacy and potentially inappropriate medication (PIM) in Swiss nursing home residents (NHR).
METHODS
Using administrative claims data provided by the Swiss health insurance company Helsana, we assessed drug claims and drug costs in 2016 in individuals aged ≥65 years and insured with Helsana, who were either NHR or living in the community (reference group, RG). In particular, we analysed the prevalence of polypharmacy (≥5 claims for different drugs during a 3-month period) and PIM use according to the 2015 Beers criteria and the PRISCUS list. We standardised the results to the Swiss population.
RESULTS
In 2016, NHR had on average nearly twice as many drug claims per capita as individuals in the RG (NHR 58.8; RG 30.8). The average per capita drug costs per day for NHR were low, but higher than in the RG (NHR CHF 8.55; RG CHF 5.45). The same pattern applied to the prevalence of polypharmacy (NHR 85.5%; RG 50.4%). Standardisation by age and sex did not materially alter these observations. Overall, 79.1% of NHR received ≥1 PIM, and 56.2% were long-term users (≥3 claims) of at least one PIM (based on the combined PRISCUS list and Beers criteria). Among all PIMs in nursing homes, quetiapine (antipsychotic agent), lorazepam (anxiolytic agent) and zolpidem (hypnotic agent) were the most prevalent (22.4, 20.2 and 13.0%, respectively).
CONCLUSIONS
The high prevalence of polypharmacy and PIM in Swiss nursing homes may indicate a need for interventions aiming at de-prescribing drugs with an unfavourable benefit-risk profile.
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| first_indexed | 2024-04-12T00:25:20Z |
| format | Article |
| id | doaj.art-4deba4ced6bb4b9fabb04367152af6f6 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-12T00:25:20Z |
| publishDate | 2019-09-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-4deba4ced6bb4b9fabb04367152af6f62022-12-22T03:55:33ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972019-09-01149394010.4414/smw.2019.20126Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims dataRahel Schneider0Daphne Reinau1Nadine Schur2Eva Blozik3Mathias Früh4Andri Signorell5Christoph R. Meier6Matthias Schwenkglenks7Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, SwitzerlandBasel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, SwitzerlandInstitute of Pharmaceutical Medicine (ECPM), University of Basel, SwitzerlandDepartment of Health Sciences, Helsana Group, Zurich, SwitzerlandDepartment of Health Sciences, Helsana Group, Zurich, SwitzerlandDepartment of Health Sciences, Helsana Group, Zurich, SwitzerlandBasel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Switzerland; Boston Collaborative Drug Surveillance Program, Lexington, MA, USAInstitute of Pharmaceutical Medicine (ECPM), University of Basel, Switzerland BACKGROUND To date, comprehensive data on drug utilisation in Swiss nursing homes are lacking. OBJECTIVE To describe drug prescription patterns, polypharmacy and potentially inappropriate medication (PIM) in Swiss nursing home residents (NHR). METHODS Using administrative claims data provided by the Swiss health insurance company Helsana, we assessed drug claims and drug costs in 2016 in individuals aged ≥65 years and insured with Helsana, who were either NHR or living in the community (reference group, RG). In particular, we analysed the prevalence of polypharmacy (≥5 claims for different drugs during a 3-month period) and PIM use according to the 2015 Beers criteria and the PRISCUS list. We standardised the results to the Swiss population. RESULTS In 2016, NHR had on average nearly twice as many drug claims per capita as individuals in the RG (NHR 58.8; RG 30.8). The average per capita drug costs per day for NHR were low, but higher than in the RG (NHR CHF 8.55; RG CHF 5.45). The same pattern applied to the prevalence of polypharmacy (NHR 85.5%; RG 50.4%). Standardisation by age and sex did not materially alter these observations. Overall, 79.1% of NHR received ≥1 PIM, and 56.2% were long-term users (≥3 claims) of at least one PIM (based on the combined PRISCUS list and Beers criteria). Among all PIMs in nursing homes, quetiapine (antipsychotic agent), lorazepam (anxiolytic agent) and zolpidem (hypnotic agent) were the most prevalent (22.4, 20.2 and 13.0%, respectively). CONCLUSIONS The high prevalence of polypharmacy and PIM in Swiss nursing homes may indicate a need for interventions aiming at de-prescribing drugs with an unfavourable benefit-risk profile. https://www.smw.ch/index.php/smw/article/view/2674claims datadescriptive studydrug utilisationHelsananursing homepolypharmacy |
| spellingShingle | Rahel Schneider Daphne Reinau Nadine Schur Eva Blozik Mathias Früh Andri Signorell Christoph R. Meier Matthias Schwenkglenks Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims data Swiss Medical Weekly claims data descriptive study drug utilisation Helsana nursing home polypharmacy |
| title | Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims data |
| title_full | Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims data |
| title_fullStr | Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims data |
| title_full_unstemmed | Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims data |
| title_short | Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims data |
| title_sort | drug prescription patterns polypharmacy and potentially inappropriate medication in swiss nursing homes a descriptive analysis based on claims data |
| topic | claims data descriptive study drug utilisation Helsana nursing home polypharmacy |
| url | https://www.smw.ch/index.php/smw/article/view/2674 |
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