engleski

Drug burden index in older community dwelling patients in Croatia: preliminary results from the Croatian study sample of the EUROAGEISM ESR7 H2020 project

Aging population is at increased risk of negative health outcomes due to the use of potentially inappropriate medications. This study aimed to evaluate the anticholinergic and sedative medication burden and its correlation with patients’ sociodemographic and health-related characteristics in older patients. Setting and Method: Data for this observational, cross- sectional study were collected using the EUROAGEISM H2020 ESR 7 project protocol in three community pharmacies in Zagreb. Presented data are preliminary and include 84 adults aged 65 + years who were able and willing to give their informed consent. Collected data were analysed using IBM SPSS v 20. Main outcome measures: Drug Burden Index (DBI) ; clinical and functional factors (hospitalizations, falls and emergency department visits during last year, mobility and strength, frailty score, number of used medications and self-reported health). Results: 84 respondents were included in the study (67.9% female ; median age 73 (interquartile range 68–80)). Polypharmacy (5 + medications) was identified in 67.8% patients and 51.2% used 1 + medication from DBI list. Women were prescribed DBI medications more often (59, 6% vs 33, 3% ; p = 0, 024) and had DBI index higher than men (0.62 ± 0.72 vs 0.24 ± 0.44) (p = 0, 004). The most commonly prescribed DBI drug classes were anxiolytics (58.6%), mostly benzodiazepines, followed by antidepressants and analgesics. The most prevalent were sedative DBI medications ; diazepam 22.6%, alprazolam 13.1%, tramadol 8.3%, zolpidem 6.0%, respectively, while the only anticholinergic medication was trospium, prescribed to 3.6% of patients. A positive correlation was observed between DBI index and the number of prescribed medications and frailty score (ρ = 0.51, p < 0.001 ; ρ = 0.26, p = 0.019, respectively), while correlation found between DBI index and self-reported health was negative (ρ = −0.32, p = 0.003). Conclusion: Higher DBI was found in women and participants with polypharmacy. Patients with higher DBI scored higher on frailty test, and reported their health status as worse. These findings indicate additional attention is needed when providing care to these patients and warrants considering the need for potential deprescribing. Grant support: the EUROAGEISM H2020-MCSF-ITN- 764632 project, INOMED project (CZ.02.1.01/0.0/0.0/18_069/0010046), PROGRESS Q42, Faculty of Pharmacy, Charles University (KSKF-2 Assoc. Prof. Fialova) and SVV 260, 417.

aging, drug burden index, polypharmacy

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