Symptomatic and preventive medication use according to age and frailty in Australian and Japanese nursing homes,Aging Clinical and Experimental Research

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Symptomatic and preventive medication use according to age and frailty in Australian and Japanese nursing homes
Aging Clinical and Experimental Research ( IF 3.4 ) Pub Date : 2023-11-07 , DOI: 10.1007/s40520-023-02600-x
Shin J Liau ₁ , Shota Hamada _{2,

3,

4} , Agathe D Jadczak ₅ , Nobuo Sakata _{4,

6} , Samanta Lalic _{1,

7} , Rumiko Tsuchiya-Ito ₂ , Reina Taguchi ₂ , Renuka Visvanathan ₅ , J Simon Bell ₁

Affiliation

Objective

To investigate symptomatic and preventive medication use according to age and frailty in Australian and Japanese nursing homes (NHs).

Methods

Secondary cross-sectional analyses of two prospective cohort studies involving 12 Australian NHs and four Japanese NHs. Frailty was measured using the FRAIL-NH scale (non-frail 0–2; frail 3–6; most-frail 7–14). Regular medications were classified as symptomatic or preventive based on published lists and expert consensus. Descriptive statistics were used to compare the prevalence and ratio of symptomatic to preventive medications.

Results

Overall, 550 Australian residents (87.7 ± 7.3 years; 73.3% females) and 333 Japanese residents (86.5 ± 7.0 years; 73.3% females) were included. Australian residents used a higher mean number of medications than Japanese residents (9.8 ± 4.0 vs 7.7 ± 3.7, p < 0.0001). Australian residents used more preventive than symptomatic medications (5.5 ± 2.5 vs 4.3 ± 2.6, p < 0.0001), while Japanese residents used more symptomatic than preventive medications (4.7 ± 2.6 vs 3.0 ± 2.2, p < 0.0001). In Australia, symptomatic medications were more prevalent with increasing frailty (non-frail 3.4 ± 2.6; frail 4.0 ± 2.6; most-frail 4.8 ± 2.6, p < 0.0001) but less prevalent with age (< 80 years 5.0 ± 2.9; 80–89 years 4.4 ± 2.6; ≥ 90 years 3.9 ± 2.5, p = 0.0042); while preventive medications remained similar across age and frailty groups. In Japan, there was no significant difference in the mean number of symptomatic and preventive medications irrespective of age and frailty.

Conclusions

The ratio of symptomatic to preventive medications was higher with increasing frailty but lower with age in Australia; whereas in Japan, the ratio remained consistent across age and frailty groups. Preventive medications remained prevalent in most-frail residents in both cohorts, albeit at lower levels in Japan.

中文翻译：

澳大利亚和日本疗养院根据年龄和虚弱情况使用对症和预防性药物

客观的

根据澳大利亚和日本疗养院 (NH) 的年龄和虚弱程度调查对症和预防性药物的使用情况。

方法

对涉及 12 名澳大利亚 NH 和 4 名日本 NH 的两项前瞻性队列研究进行二次横断面分析。使用 FRAIL-NH 量表测量虚弱程度（非虚弱 0-2；虚弱 3-6；最虚弱 7-14）。根据已发布的清单和专家共识，常规药物被分为症状性药物或预防性药物。使用描述性统计数据来比较症状性药物与预防性药物的患病率和比率。

结果

总体而言，包括 550 名澳大利亚居民（87.7 ± 7.3 岁；73.3% 女性）和 333 名日本居民（86.5 ± 7.0 岁；73.3% 女性）。澳大利亚居民使用的平均药物数量高于日本居民（9.8 ± 4.0 vs 7.7 ± 3.7， p < 0.0001）。澳大利亚居民使用的预防性药物多于对症药物（5.5 ± 2.5 vs 4.3 ± 2.6， p < 0.0001），而日本居民使用的对症药物多于预防性药物（4.7 ± 2.6 vs 3.0 ± 2.2， p < 0.0001）。在澳大利亚，随着虚弱程度的增加，对症药物治疗更为普遍（非虚弱 3.4 ± 2.6；虚弱 4.0 ± 2.6；最虚弱 4.8 ± 2.6， p < 0.0001），但随着年龄的增长，对症药物的使用率降低（< 80 岁 5.0 ± 2.9；80– 89 年 4.4 ± 2.6；≥ 90 年 3.9 ± 2.5， p = 0.0042）；而不同年龄和体弱人群的预防药物保持相似。在日本，无论年龄和体质如何，对症和预防药物的平均数量没有显着差异。