The impact of decreasing potentially inappropriate medications on activities of daily living in a convalescent rehabilit

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RESEARCH ARTICLE

The impact of decreasing potentially inappropriate medications on activities of daily living in a convalescent rehabilitation setting Eiji Kose1   · Toshiyuki Hirai2 · Toshiichi Seki2 · Nobuhiro Yasuno1,3 Received: 3 April 2020 / Accepted: 22 September 2020 © Springer Nature Switzerland AG 2020

Abstract Background Polypharmacy or potentially inappropriate medications negatively affect the functional recovery of rehabilitation. However, limited research exists regarding the effect of decreasing in potentially inappropriate medications use on functional improvement of rehabilitation in geriatric Japanese patients. Objective To elucidate whether decreasing PIM during hospitalization could be a predictor of rehabilitation outcomes among geriatric patients in a convalescent rehabilitation setting. Setting This study was conducted at the convalescent rehabilitation ward in the Hitachinaka General Hospital in Japan. Methods This retrospective observational cohort study included consecutive geriatric patients admitted at the convalescent rehabilitation ward between 2010 and 2018. Participants were divided based on presence or absence of decreasing in potentially inappropriate medications use during hospitalization. A multiple linear regression analysis was performed to analyze whether decreasing potentially inappropriate medications use during hospitalization could be a predictor of Functional Independence Measure-Motor at discharge. Main outcome measures The primary outcome was the Functional Independence Measure-Motor at discharge. Results In total, 569 participants (interquartile range 73–85 years; 33.6% men) were included in the present study. A multiple linear regression analysis of Functional Independence Measure-Motor at discharge, adjusting for confounding factors, revealed that decreasing in potentially inappropriate medications use was independently correlated with Functional Independence Measure-Motor at discharge. In particular, the use of first-generation antihistamines, antipsychotics, benzodiazepines, and non-steroidal anti-inflammatory drugs among potentially inappropriate medications decreased significantly during hospitalization. Conclusion Decreased potentially inappropriate medications use during hospitalization may be a predictor of improvement of rehabilitation outcomes in geriatric patients. Keywords  Convalescent rehabilitation · Functional independence measure · Geriatric patients · Potentially inappropriate medications

Impacts on Practice • The decreased potentially inappropriate medications use

* Eiji Kose [email protected]‑u.ac.jp 1



Department of Pharmacy, Teikyo University School of Medicine University Hospital, 2‑11‑1 Kaga, Itabashi‑ku, Tokyo 173‑8606, Japan

2



Department of Pharmacy, Hitachinaka General Hospital, 20‑1 Ishikawachou, Hitachinaka‑shi, Ibaraki 312‑0057, Japan

3

Laboratory of Hospital Pharmacy, School of Pharmacy, Teikyo University, 2‑11‑1 Kaga, Itabashi‑ku, Tokyo 173‑8606, Japan



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