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. 2016 Oct;11(10):694-700.
doi: 10.1002/jhm.2614. Epub 2016 Jun 3.

Medications associated with geriatric syndromes and their prevalence in older hospitalized adults discharged to skilled nursing facilities

Avantika A Saraf  1   2 , Alec W Petersen  3 , Sandra F Simmons  1   4   5 , John F Schnelle  1   4   5 , Susan P Bell  1   2   4 , Sunil Kripalani  6   7 , Amy P Myers  8 , Amanda S Mixon  5   6   7 , Emily A Long  1 , J Mary Lou Jacobsen  1   5 , Eduard E Vasilevskis  9   10   11
Affiliations

Medications associated with geriatric syndromes and their prevalence in older hospitalized adults discharged to skilled nursing facilities

Avantika A Saraf et al. J Hosp Med. 2016 Oct.

Abstract

Background: More than half of the hospitalized older adults discharged to skilled nursing facilities (SNFs) have more than 3 geriatric syndromes. Pharmacotherapy may be contributing to geriatric syndromes in this population.

Objectives: Develop a list of medications associated with geriatric syndromes and describe their prevalence in patients discharged from acute care to SNFs.

Design: Literature review and multidisciplinary expert panel discussion, followed by cross-sectional analysis.

Setting: Academic medical center in the United States PARTICIPANTS: One hundred fifty-four hospitalized Medicare beneficiaries discharged to SNFs.

Measurements: Development of a list of medications that are associated with 6 geriatric syndromes. Prevalence of the medications associated with geriatric syndromes was examined in the hospital discharge sample.

Results: A list of 513 medications was developed as potentially contributing to 6 geriatric syndromes: cognitive impairment, delirium, falls, reduced appetite or weight loss, urinary incontinence, and depression. Medications included 18 categories. Antiepileptics were associated with all syndromes, whereas antipsychotics, antidepressants, antiparkinsonism, and opioid agonists were associated with 5 geriatric syndromes. In the prevalence sample, patients were discharged to SNFs with an overall average of 14.0 (±4.7) medications, including an average of 5.9 (±2.2) medications that could contribute to geriatric syndromes, with falls having the most associated medications at discharge at 5.5 (±2.2).

Conclusions: Many commonly prescribed medications are associated with geriatric syndromes. Over 40% of all medications ordered upon discharge to SNFs were associated with geriatric syndromes and could be contributing to the high prevalence of geriatric syndromes experienced by this population. Journal of Hospital Medicine 2016;11:694-700. © 2016 Society of Hospital Medicine.

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Conflict of interest statement

Each co-author contributed significantly to the manuscript. Dr. Kripalani has received stock/stock options from Bioscape Digital, LLC. None of the other authors have significant conflicts of interest to report related to this project or the results reported within this manuscript.

Figures

Figure 1
Figure 1
Conceptual Model and Approach for Development of the Medication Associated with Geriatric Syndromes (MAGS) List (Phase 1)
See this image and copyright information in PMC

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