Medications Associated With Geriatric Syndromes and Their Prevalence in Older Hospitalized Adults Discharged to Skilled Nursing Facilities


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Abstract

BACKGROUNDMore 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.OBJECTIVESDevelop a list of medications associated with geriatric syndromes and describe their prevalence in patients discharged from acute care to SNFs.DESIGNLiterature review and multidisciplinary expert panel discussion, followed by cross-sectional analysis.SETTINGAcademic medical center in the United StatesPARTICIPANTSOne hundred fifty-four hospitalized Medicare beneficiaries discharged to SNFs.MEASUREMENTSDevelopment 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.RESULTSA 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).CONCLUSIONSMany 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.

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