Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.19/7528 |
Resumo: | Background: Falls are a major public health issue, given their prevalence and social impact. Older adults living in long-term care facilities (LTCF) are at greater risk of injury resulting from a fall due to multiple factors, such as nutritional, functional/cognitive impairment, postural instability, polypharmacy, and the presence of potentially inappropriate medications (PIMs). Medication management in LTCF is complex and often sub-optimal and might be crucial for falls. Pharmacist intervention is important, since they have a unique knowledge of medication. However, studies mapping the impact of pharmaceutical activities in Portuguese LTC settings are scarce. Objective: This study aims to assess the characteristics of older adult fallers living in LTFCs and examine the relationship between falling and several factors in this population. We also intend to explore the prevalence of PIMs and their relationship with the occurrence of falls. Methods: The study was conducted in two long-term care facilities for elderly people, in the central region of Portugal. We included patients aged 65 and older with no reduced mobility or physical weakness and with the ability to understand spoken and written Portuguese. The following information was assessed: sociodemographic characteristics, comorbidities, polypharmacy, fear of falling, functional, nutritional and cognitive status. PIMs were evaluated according to the Beers criteria (2019). Results: A total of 69 institutionalised older adults, 45 women and 24 men, with a mean age of 83.14 ± 8.87 years were included. The prevalence of falls was 21.74% Out of these, 46.67% (n=7) fell once, 13.33% (n=2) fell twice, and 40% (n=6) fell 3 or more times. Fallers were mainly women, had lower levels of education, were well nourished, had moderate to severe levels of dependence, and displayed moderate cognitive impairment. All adult fallers had a fear of falling. The main comorbidities of this population were related to the cardiovascular system. Polypharmacy was present in every patient, and at least one PIM was identified in 88.41% of the subjects. Fear of falling (FOF) and cognitive impairment (in subjects with 1 to 11 years of education) showed statistically significant associations with the occurrence of falls (p=0.005 and p=0.05, respectively). No significant differences were found between fallers and non-fallers for any other factors. Conclusions: This present study is a preliminary contribution to characterise a group of older adult fallers living in Portuguese LTCFs and demonstrated that fear of falling and cognitive impairment are associated with the occurrence of falls in this population. The high prevalence of polypharmacy and PIMs emphasises the need for tailored interventions featuring the collaboration of a pharmacist to optimise medication management in this population. |
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Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary studyOlder adultsFallsPharmacistPharmacistPolypharmacyPotentially inappropriate medications (PIMs)Long-term care facilitiesBackground: Falls are a major public health issue, given their prevalence and social impact. Older adults living in long-term care facilities (LTCF) are at greater risk of injury resulting from a fall due to multiple factors, such as nutritional, functional/cognitive impairment, postural instability, polypharmacy, and the presence of potentially inappropriate medications (PIMs). Medication management in LTCF is complex and often sub-optimal and might be crucial for falls. Pharmacist intervention is important, since they have a unique knowledge of medication. However, studies mapping the impact of pharmaceutical activities in Portuguese LTC settings are scarce. Objective: This study aims to assess the characteristics of older adult fallers living in LTFCs and examine the relationship between falling and several factors in this population. We also intend to explore the prevalence of PIMs and their relationship with the occurrence of falls. Methods: The study was conducted in two long-term care facilities for elderly people, in the central region of Portugal. We included patients aged 65 and older with no reduced mobility or physical weakness and with the ability to understand spoken and written Portuguese. The following information was assessed: sociodemographic characteristics, comorbidities, polypharmacy, fear of falling, functional, nutritional and cognitive status. PIMs were evaluated according to the Beers criteria (2019). Results: A total of 69 institutionalised older adults, 45 women and 24 men, with a mean age of 83.14 ± 8.87 years were included. The prevalence of falls was 21.74% Out of these, 46.67% (n=7) fell once, 13.33% (n=2) fell twice, and 40% (n=6) fell 3 or more times. Fallers were mainly women, had lower levels of education, were well nourished, had moderate to severe levels of dependence, and displayed moderate cognitive impairment. All adult fallers had a fear of falling. The main comorbidities of this population were related to the cardiovascular system. Polypharmacy was present in every patient, and at least one PIM was identified in 88.41% of the subjects. Fear of falling (FOF) and cognitive impairment (in subjects with 1 to 11 years of education) showed statistically significant associations with the occurrence of falls (p=0.005 and p=0.05, respectively). No significant differences were found between fallers and non-fallers for any other factors. Conclusions: This present study is a preliminary contribution to characterise a group of older adult fallers living in Portuguese LTCFs and demonstrated that fear of falling and cognitive impairment are associated with the occurrence of falls in this population. The high prevalence of polypharmacy and PIMs emphasises the need for tailored interventions featuring the collaboration of a pharmacist to optimise medication management in this population.Repositório Científico do Instituto Politécnico de ViseuRamos Ferreira, CarinaFilipa, Mascarenhas-MeloRodrigues, Ana RitaJ. Reis Lima, M.Pinheiro, JoaoMargarida Correia Balula Chaves, CláudiaTeixeira-Lemos, EditeBell, Victoria2023-01-12T16:17:45Z2022-12-022022-12-02T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.19/7528engFerreira CR, MASCARENHAS-MELO F, Rodrigues AR, Lima MJR, Pinheiro JP, CHAVES C, Teixeira-Lemos E, Bell V. Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study. Pharm Pract (Granada) [Internet]. 2022 Dec. 2 [cited 2023 Jan. 12];20(4):1-10. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/279910.18549/PharmPract.2022.4.2717info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-01-16T15:29:40Zoai:repositorio.ipv.pt:10400.19/7528Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:45:15.102867Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study |
title |
Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study |
spellingShingle |
Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study Ramos Ferreira, Carina Older adults Falls Pharmacist Pharmacist Polypharmacy Potentially inappropriate medications (PIMs) Long-term care facilities |
title_short |
Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study |
title_full |
Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study |
title_fullStr |
Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study |
title_full_unstemmed |
Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study |
title_sort |
Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study |
author |
Ramos Ferreira, Carina |
author_facet |
Ramos Ferreira, Carina Filipa, Mascarenhas-Melo Rodrigues, Ana Rita J. Reis Lima, M. Pinheiro, Joao Margarida Correia Balula Chaves, Cláudia Teixeira-Lemos, Edite Bell, Victoria |
author_role |
author |
author2 |
Filipa, Mascarenhas-Melo Rodrigues, Ana Rita J. Reis Lima, M. Pinheiro, Joao Margarida Correia Balula Chaves, Cláudia Teixeira-Lemos, Edite Bell, Victoria |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Instituto Politécnico de Viseu |
dc.contributor.author.fl_str_mv |
Ramos Ferreira, Carina Filipa, Mascarenhas-Melo Rodrigues, Ana Rita J. Reis Lima, M. Pinheiro, Joao Margarida Correia Balula Chaves, Cláudia Teixeira-Lemos, Edite Bell, Victoria |
dc.subject.por.fl_str_mv |
Older adults Falls Pharmacist Pharmacist Polypharmacy Potentially inappropriate medications (PIMs) Long-term care facilities |
topic |
Older adults Falls Pharmacist Pharmacist Polypharmacy Potentially inappropriate medications (PIMs) Long-term care facilities |
description |
Background: Falls are a major public health issue, given their prevalence and social impact. Older adults living in long-term care facilities (LTCF) are at greater risk of injury resulting from a fall due to multiple factors, such as nutritional, functional/cognitive impairment, postural instability, polypharmacy, and the presence of potentially inappropriate medications (PIMs). Medication management in LTCF is complex and often sub-optimal and might be crucial for falls. Pharmacist intervention is important, since they have a unique knowledge of medication. However, studies mapping the impact of pharmaceutical activities in Portuguese LTC settings are scarce. Objective: This study aims to assess the characteristics of older adult fallers living in LTFCs and examine the relationship between falling and several factors in this population. We also intend to explore the prevalence of PIMs and their relationship with the occurrence of falls. Methods: The study was conducted in two long-term care facilities for elderly people, in the central region of Portugal. We included patients aged 65 and older with no reduced mobility or physical weakness and with the ability to understand spoken and written Portuguese. The following information was assessed: sociodemographic characteristics, comorbidities, polypharmacy, fear of falling, functional, nutritional and cognitive status. PIMs were evaluated according to the Beers criteria (2019). Results: A total of 69 institutionalised older adults, 45 women and 24 men, with a mean age of 83.14 ± 8.87 years were included. The prevalence of falls was 21.74% Out of these, 46.67% (n=7) fell once, 13.33% (n=2) fell twice, and 40% (n=6) fell 3 or more times. Fallers were mainly women, had lower levels of education, were well nourished, had moderate to severe levels of dependence, and displayed moderate cognitive impairment. All adult fallers had a fear of falling. The main comorbidities of this population were related to the cardiovascular system. Polypharmacy was present in every patient, and at least one PIM was identified in 88.41% of the subjects. Fear of falling (FOF) and cognitive impairment (in subjects with 1 to 11 years of education) showed statistically significant associations with the occurrence of falls (p=0.005 and p=0.05, respectively). No significant differences were found between fallers and non-fallers for any other factors. Conclusions: This present study is a preliminary contribution to characterise a group of older adult fallers living in Portuguese LTCFs and demonstrated that fear of falling and cognitive impairment are associated with the occurrence of falls in this population. The high prevalence of polypharmacy and PIMs emphasises the need for tailored interventions featuring the collaboration of a pharmacist to optimise medication management in this population. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-12-02 2022-12-02T00:00:00Z 2023-01-12T16:17:45Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.19/7528 |
url |
http://hdl.handle.net/10400.19/7528 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Ferreira CR, MASCARENHAS-MELO F, Rodrigues AR, Lima MJR, Pinheiro JP, CHAVES C, Teixeira-Lemos E, Bell V. Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study. Pharm Pract (Granada) [Internet]. 2022 Dec. 2 [cited 2023 Jan. 12];20(4):1-10. Available from: https://www.pharmacypractice.org/index.php/pp/article/view/2799 10.18549/PharmPract.2022.4.2717 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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