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Associations between inappropriate medication use and (instrumental) activities of daily living in geriatric rehabilitation inpatients: RESORT study

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Abstract

Background

Inappropriate medication use can affect functional independence in older adults.

Aims

The aim of the study is to examine associations between potentially inappropriate medication use and Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in geriatric rehabilitation inpatients.

Methods

A longitudinal, prospective, observational study was undertaken at a teaching hospital. Potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) were measured at acute admission, and at admission and discharge from geriatric rehabilitation. Associations between PIM and PPO use and ADL and IADL scores were examined at admission to geriatric rehabilitation, discharge and 3-month post-discharge.

Results

A total of 693 inpatients were included. At the 3-month post-discharge, PPOs were associated with lower IADL scores (incident rate ratio = 0.868, 95% CI 0.776–0.972). There were no significant associations between PIMs and PPOs use at admission to geriatric rehabilitation with longitudinal changes of ADLs and IADLs from geriatric rehabilitation admission to 3-month post-discharge Renal PIMs were associated with higher IADL scores at 3-month post-discharge (incidence rate ratio = 1.750, 95% CI 1.238–2.474). At 3-month post-discharge, PPOs involving vaccinations were associated with a lower IADL score (incident risk ratio = 0.844, 95% CI 0.754–0.944).

Conclusions

Inappropriate medication use involving PPOs was associated with lower IADL scores at 3-month post-discharge from geriatric rehabilitation but not with ADL scores. Greater attention is needed in reducing PPOs in geriatric rehabilitation inpatients that can potentially impact IADLs. In the community, health professionals need to be vigilant about assessing how older patients’ physical functioning may be affected by inappropriate medication prescribing.

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Acknowledgements

The authors thank the multidisciplinary team members of the Royal Melbourne Hospital, Royal Park Campus, involved in the RESORT study for their clinical work and the @AgeMelbourne team for their role in the data collection.

Funding

Medical Research Future Fund provided by the Melbourne Academic Center of Health.

Author information

Authors and Affiliations

  1. School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, 221 Burwood Highway, Burwood, VIC, 3125, Australia

    Elizabeth Manias

  2. Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, 300 Grattan Street, Parkville, VIC, 3050, Australia

    Elizabeth Manias

  3. Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, 300 Grattan Street, Parkville, VIC, 3050, Australia

    Cheng Hwee Soh, Md. Zunayed Kabir, Esmee M. Reijnierse & Andrea B. Maier

  4. Department of Rehabilitation Medicine, Amsterdam UMC, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands

    Esmee M. Reijnierse

  5. @AgeAmsterdam, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands

    Andrea B. Maier

  6. Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Andrea B. Maier

  7. Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Singapore

    Andrea B. Maier

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  1. Elizabeth Manias
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  2. Cheng Hwee Soh
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  3. Md. Zunayed Kabir
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  4. Esmee M. Reijnierse
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by EM, CHS, MZK, EMR, and ABM. The first draft of the manuscript was written by EM and all authors reviewed and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Elizabeth Manias.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Melbourne Health Human Research Ethics Committee, HREC/17/MH/103) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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All participants or their nominated proxies provided written informed consent.

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Manias, E., Soh, C.H., Kabir, M.Z. et al. Associations between inappropriate medication use and (instrumental) activities of daily living in geriatric rehabilitation inpatients: RESORT study. Aging Clin Exp Res 34, 445–454 (2022). https://doi.org/10.1007/s40520-021-01946-4

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  • DOI: https://doi.org/10.1007/s40520-021-01946-4

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