An Evaluation of the Central Nervous System Medication Use and Frailty among Residents of Aged Care Homes in Malaysia

Syed Shahzad Hasan, Chia Siang Kow, Kaeshaelya Thiruchelvam, David Weng Kwai Chong, Syed Imran Ahmed

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Abstract

Background/Aims: Old age and institutionalization in care homes are associated with increased use of risk medications affecting the central nervous system (CNS). This study evaluated medication utilization and appropriateness; and assessed frailty among residents of Malaysian aged care homes. Methods: The subjects of this study included 202 elderly (≥65 years) residents of 17 aged care homes in suburban peninsular Malaysia. Frailty was measured using the Groningen Frailty Indicator (GFI) score and independence in daily living was measured as KATZ activity of daily living score. Medication appropriateness was assessed using the Medication Appropriateness Index (MAI) and 2015 Beers' criteria for Potentially Inappropriate Medication (PIM). Results: CNS medications constituted about 16% of the total, with an average of 0.8 ± 1.1 medications per resident, which reduced to 0.5 ± 0.8 medications after 3 months. Frailty (154/202) and polypharmacy (90/202) were highly prevalent in study subjects. Subjects on CNS medications had significantly higher GFI score (7.1 vs. 5.9; p = 0.031), polypharmacy (57.8 vs. 35.3%; p = 0.002), number of PIMs (0.9 vs. 0.2; p = 0.001), and mean summed MAI score (3.6 vs. 2.6; p = 0.015) than subjects not on CNS medications. Medication number was also significantly correlated with GFI (r = 0.194; p = 0.006) and KATZ (r = 0.141; p = 0.046) scores. Conclusion: Frailty and polypharmacy were highly prevalent among aged care home subjects taking CNS medications. These findings support the notion that periodic regular medication review should improve the overall use of medications in elderly patients.

LanguageEnglish
Pages82-90
Number of pages9
JournalNeuroepidemiology
Volume49
Issue number1-2
Early online date12 Sep 2017
DOIs
Publication statusPublished - 1 Oct 2017
Externally publishedYes

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Homes for the Aged
Malaysia
Home Care Services
Central Nervous System
Polypharmacy
Institutionalization
Activities of Daily Living
Potentially Inappropriate Medication List

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Hasan, Syed Shahzad ; Kow, Chia Siang ; Thiruchelvam, Kaeshaelya ; Chong, David Weng Kwai ; Ahmed, Syed Imran. / An Evaluation of the Central Nervous System Medication Use and Frailty among Residents of Aged Care Homes in Malaysia. In: Neuroepidemiology. 2017 ; Vol. 49, No. 1-2. pp. 82-90.
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An Evaluation of the Central Nervous System Medication Use and Frailty among Residents of Aged Care Homes in Malaysia. / Hasan, Syed Shahzad; Kow, Chia Siang; Thiruchelvam, Kaeshaelya; Chong, David Weng Kwai; Ahmed, Syed Imran.

In: Neuroepidemiology, Vol. 49, No. 1-2, 01.10.2017, p. 82-90.

Research output: Contribution to journalArticle

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AB - Background/Aims: Old age and institutionalization in care homes are associated with increased use of risk medications affecting the central nervous system (CNS). This study evaluated medication utilization and appropriateness; and assessed frailty among residents of Malaysian aged care homes. Methods: The subjects of this study included 202 elderly (≥65 years) residents of 17 aged care homes in suburban peninsular Malaysia. Frailty was measured using the Groningen Frailty Indicator (GFI) score and independence in daily living was measured as KATZ activity of daily living score. Medication appropriateness was assessed using the Medication Appropriateness Index (MAI) and 2015 Beers' criteria for Potentially Inappropriate Medication (PIM). Results: CNS medications constituted about 16% of the total, with an average of 0.8 ± 1.1 medications per resident, which reduced to 0.5 ± 0.8 medications after 3 months. Frailty (154/202) and polypharmacy (90/202) were highly prevalent in study subjects. Subjects on CNS medications had significantly higher GFI score (7.1 vs. 5.9; p = 0.031), polypharmacy (57.8 vs. 35.3%; p = 0.002), number of PIMs (0.9 vs. 0.2; p = 0.001), and mean summed MAI score (3.6 vs. 2.6; p = 0.015) than subjects not on CNS medications. Medication number was also significantly correlated with GFI (r = 0.194; p = 0.006) and KATZ (r = 0.141; p = 0.046) scores. Conclusion: Frailty and polypharmacy were highly prevalent among aged care home subjects taking CNS medications. These findings support the notion that periodic regular medication review should improve the overall use of medications in elderly patients.

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