Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 May;25(5):876-883.
doi: 10.1016/j.jamda.2024.01.015. Epub 2024 Feb 26.

Deprescribing Opportunities for Frail Residents of Nursing Homes: A Multicenter Study in Australia, China, Japan, and Spain

Shin J Liau  1 , Meng Zhao  2 , Shota Hamada  3 , Marta Gutiérrez-Valencia  4 , Agathe D Jadczak  5 , Li Li  2 , Nicolás Martínez-Velilla  6 , Nobuo Sakata  7 , Peipei Fu  8 , Renuka Visvanathan  5 , Samanta Lalic  9 , Victoria Roncal-Belzunce  10 , J Simon Bell  11
Affiliations
Multicenter Study

Deprescribing Opportunities for Frail Residents of Nursing Homes: A Multicenter Study in Australia, China, Japan, and Spain

Shin J Liau et al. J Am Med Dir Assoc. 2024 May.

Abstract

Objective: Deprescribing opportunities may differ across health care systems, nursing home settings, and prescribing cultures. The objective of this study was to compare the prevalence of STOPPFrail medications according to frailty status among residents of nursing homes in Australia, China, Japan, and Spain.

Design: Secondary cross-sectional analyses of data from 4 cohort studies.

Setting and participants: A total of 1142 residents in 31 nursing homes.

Methods: Medication data were extracted from resident records. Frailty was assessed using the FRAIL-NH scale (non-frail 0-2; frail 3-6; most-frail 7-14). Chi-square tests and prevalence ratios (PRs) were used to compare STOPPFrail medication use across cohorts.

Results: In total, 84.7% of non-frail, 95.6% of frail, and 90.6% of most-frail residents received ≥1 STOPPFrail medication. Overall, the most prevalent STOPPFrail medications were antihypertensives (53.0% in China to 73.3% in Australia, P < .001), vitamin D (nil in China to 52.7% in Australia, P < .001), lipid-lowering therapies (11.1% in Japan to 38.9% in Australia, P < .001), aspirin (13.5% in Japan to 26.2% in China, P < .001), proton pump inhibitors (2.1% in Japan to 32.0% in Australia, P < .001), and antidiabetic medications (12.3% in Japan to 23.5% in China, P = .010). Overall use of antihypertensives (PR, 1.15; 95% CI, 1.06-1.25), lipid-lowering therapies (PR, 1.78; 95% CI, 1.45-2.18), aspirin (PR, 1.31; 95% CI, 1.04-1.64), and antidiabetic medications (PR, 1.31; 95% CI, 1.00-1.72) were more prevalent among non-frail and frail residents compared with most-frail residents. Antihypertensive use was more prevalent with increasing frailty in China and Japan, but less prevalent with increasing frailty in Australia. Antidiabetic medication use was less prevalent with increasing frailty in China and Spain but was consistent across frailty groups in Australia and Japan.

Conclusions and implications: There were overall and frailty-specific variations in prevalence of different STOPPFrail medications across cohorts. This may reflect differences in prescribing cultures, application of clinical practice guidelines in the nursing home setting, and clinician or resident attitudes toward deprescribing.

Keywords: Frailty; deprescribing; medication management; medication review; nursing homes; potentially inappropriate medications.

PubMed Disclaimer

Conflict of interest statement

Disclosure Australia: J.S.B. has received grant funding or consulting funds from the NHMRC, Medical Research Future Fund, Victorian Government Department of Health and Human Services, Dementia Australia Research Foundation, Yulgilbar Foundation, Aged Care Quality and Safety Commission, Dementia Centre for Research Collaboration, Pharmaceutical Society of Australia, Society of Hospital Pharmacists of Australia, GlaxoSmithKline Supported Studies Programme, Amgen, and several aged care provider organizations unrelated to this work. All grants and consulting funds were paid to the employing institution. R.V. was previously a board member and part of the clinical governance committee of Resthaven Incorporated. R.V. is co-founder and chair of the clinical advisory group for a wearable sensor technology start-up HealthyVibes.ai. China: None. Japan: S.H. belongs to an endowed chair funded by donations from Hakue technology, PROUMED, Japan Bio Products, Towa Pharmaceutical, Yellow Eight and Sugi Holdings. S.H. received research funding from SOMPO Care Incorporated outside of this work. Spain: N.M.V. has received grants and consulting funds from UCB Biopharma and Vegenta.

Similar articles

See all similar articles

Cited by

Publication types