Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
International Journal of Clinical Pharmacy
Published in: International Journal of Clinical Pharmacy 3/2018

01-06-2018 | Research Article

The association of increased drugs use with activities of daily living and discharge outcome among elderly stroke patients

Authors: Eiji Kose, Toshiyuki Hirai, Toshiichi Seki, Hiroyuki Hayashi

Published in: International Journal of Clinical Pharmacy | Issue 3/2018

Login to get access

Abstract

Background Few systematic studies have evaluated the association between drugs and functional recovery for geriatric patients after strokes in the convalescent stage. Objective To assess the association of increased drugs during hospitalization with activities of daily living and outcome among geriatric stroke patients. Setting This study was conducted at the convalescent rehabilitation ward in the Hitachinaka General Hospital in Japan. Methods This retrospective cohort study included consecutive patients aged ≥ 65 years who had experienced stroke between 2010 and 2016. The participants were classified into two groups according to their discharge destination: home discharge group and non-home discharge group. Multiple linear regression analysis and multiple logistic regression analysis were used to examine the association of increased drugs with FIM gain and home discharge, respectively. Main outcome measures: The main outcome measures were Functional Independence Measure (FIM) gain and home discharge. Results In total, 417 participants (165 males and 252 females; mean age, 78.8 years) were assessed and classified into home discharge (n = 226) and non-home discharge (n = 191) groups. The median FIM score was 77 (interquartile range 57–96). Multiple linear regression analysis revealed that increased use of drugs during hospitalization negatively correlated with FIM gain. Multiple logistic regression analysis showed that increased use of drugs was independently associated with a low possibility of home discharge. Conclusion The increased use of drugs during hospitalization was negatively associated with both functional recovery and possibility of home discharge among geriatric stroke patients in a convalescent rehabilitation ward.
Literature
1.
Miyai I, Sonoda S, Nagai S, Takayama Y, Inoue Y, Kakehi A, et al. Results of new policies for inpatient rehabilitation coverage in Japan. Neurorehabil Neural Repair. 2015;25(6):540–7.CrossRef
2.
Tanaka H, Ueda Y, Hayashi M, Date C, Baba T, Yamashita H, et al. Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community. Stroke. 1982;13(1):62–73.CrossRefPubMed
3.
Wolf PA, D’Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991;22(3):312–8.CrossRefPubMed
4.
Iso H, Jacobs DR Jr, Wentworth D, Neaton JD, Cohen JD. Serum cholesterol levels and sixyear mortality from stroke in 350,977 men screened for the multiple risk factor intervention trial. N Engl J Med. 1989;320(14):904–10.CrossRefPubMed
5.
6.
Sonoda S, Saitoh E, Nagai S, Kawakita M, Kanada Y. Full-time integrated treatment program, a new system for stroke rehabilitation in Japan: comparison with conventional rehabilitation. Am J Phys Med Rehabil. 2004;83(2):88–93.CrossRefPubMed
7.
Hama S, Yamashita H, Kato T, Shigenobu M, Watanabe A, Sawa M, et al. Insistence on recovery’ as a positive prognostic factor in Japanese stroke patients. Psychiatry Clin Neurosci. 2008;62(4):386–95.CrossRefPubMed
8.
Dumbreck S, Flynn A, Nairn M, Wilson M, Treweek S, Mercer SW, et al. Drug-disease and drug-drug interactions: systematic examination of recommendations in 12 UK national clinical guidelines. BMJ. 2015;350:h949.CrossRefPubMedPubMedCentral
9.
Campbell SE, Seymour DG. Primrose WR; ACMEPLUS Project. A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age Ageing. 2004;33(2):110–5.CrossRefPubMed
10.
Espino DV, Bazaldua OV, Palmer RF, Mouton CP, Parchman ML, Miles TP, et al. Suboptimal medication use and mortality in an older adult community-based cohort: results from the Hispanic EPESE Study. J Gerontol A Biol Sci Med Sci. 2006;61(2):170–5.CrossRefPubMed
11.
Inouye M, Kishi K, Ikeda Y, Takada M, Katoh J, Iwahashi M, et al. Prediction of functional outcome after stroke rehabilitation. Am J Phys Med Rehabil. 2000;79(6):513–8.CrossRefPubMed
12.
Frank M, Conzelmann M, Engelter S. Prediction of discharge destination after neurological rehabilitation in stroke patients. Eur Neurol. 2010;63(4):227–33.CrossRefPubMed
13.
Massucci M, Perdon L, Agosti M, Celani MG, Righetti E, Recupero E, et al. Prognostic factors of activity limitation and discharge destination after stroke rehabilitation. Am J Phys Med Rehabil. 2006;85(12):963–70.CrossRefPubMed
14.
Jehkonen M, Ahonen JP, Dastidar P, Koivisto AM, Laippala P, Vilkki J, et al. Predictors of discharge to home during the first year after right hemisphere stroke. Acta Neurol Scand. 2001;104(3):136–41.CrossRefPubMed
15.
Shen Q, Cordato D, Chan DK, Hung WT, Karr M. Identifying the determinants of 1-year post- stroke outcomes in elderly patients. Acta Neurol Scand. 2006;113(2):114–20.CrossRefPubMed
16.
Thommessen B, Bautz-Holter E, Laake K. Predictors of outcome of rehabilitation of elderly stroke patients in a geriatric ward. Clin Rehabil. 1999;13(2):123–8.CrossRefPubMed
17.
Wee JY, Hopman WM. Stroke impairment predictors of discharge function, length of stay, and discharge destination in stroke rehabilitation. Am J Phys Med Rehabil. 2005;84(8):604–12.CrossRefPubMed
18.
McKenna K, Tooth L, Strong J, Ottenbacher K, Connell J, Cleary M. Predicting discharge outcomes for stroke patients in Australia. Am J Phys Med Rehabil. 2002;81(1):47–56.CrossRefPubMed
19.
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med. 1999;130(6):461–70.CrossRefPubMed
20.
21.
Granger Carl V. Hamilton, Bvron B, Keith, Robert A, Zielezny, Maria, Sherwin, Frances S: Advances in functional assessment in medical rehabilitation. Top Geriatr Rehabil. 1986;1:59–74.CrossRef
22.
Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. The reliability of the functional independence measure: a quantitative review. Arch Phys Med Rehabil. 1996;77(12):1226–32.CrossRefPubMed
23.
Mutai H, Furukawa T, Araki K, Misawa K, Hanihara T. Factors associated with functional recovery and home discharge in stroke patients admitted to a convalescent rehabilitation ward. Geriatr Gerontol Int. 2012;12(2):215–22.CrossRefPubMed
24.
Field TS, Gurwitz JH, Avorn J, McCormick D, Jain S, Eckler M, et al. Risk factors for adverse drug events among nursing home residents. Arch Intern Med. 2001;161(13):1629–34.CrossRefPubMed
25.
Kojima T, Akishita M, Kameyama Y, Yamaguchi K, Yamamoto H, Eto M, et al. High risk of adverse drug reactions in elderly patients taking six or more drugs: analysis of inpatient database. Geriatr Gerontol Int. 2012;12(4):761–2.CrossRefPubMed
26.
Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, Studenski SA, et al. Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc. 2006;54(6):508–13.CrossRef
27.
Barker MJ, Greenwood KM, Jackson M, Crowe SF. Cognitive effects of long-term benzodiazepine use: a meta-analysis. CNS Drugs. 2004;18(1):37–48.CrossRefPubMed
28.
Eitan N, Levin Y, Ben-Artzi E, Levy A, Neumann M. Effects of antipsychotic drugs on memory functions of schizophrenic patients. Acta Psychiatr Scand. 1992;85(1):74–6.CrossRefPubMed
29.
Heruti RJ, Lusky A, Barell V, Ohry A, Adunsky A. Cognitive status at admission: does it affect the rehabilitation outcome of elderly patients with hip fracture? Arch Phys Med Rehabil. 1999;80(4):432–6.CrossRefPubMed
30.
Langhorne P, Taylor G, Murray G, Dennis M, Anderson C, Bautz-Holter E, et al. Early supported discharge services for stroke patients: a meta-analysis of individual patients’ data. Lancet. 2005;365(9458):501–6.CrossRefPubMed
31.
Dent L, Agosti M, Franceschini M. Outcome predictors of rehabilitation for first stroke in the elderly. Eur J Phys Rehabil Med. 2008;44(1):3–11.
32.
Miyamoto H, Hagihara A, Nobutomo K. Predicting the discharge destination of rehabilitation patients using a signal detection approach. J Rehabil Med. 2008;40(4):261–8.CrossRefPubMed
33.
Fick DM, Semla TP, Beizer J, Brandt N, Dombrowski R, DuBeau CE, et al. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015;63(11):2227–46.CrossRef
34.
35.
O’Mahony D, O’Sullivan D, Byrne S, O’Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213–8.CrossRefPubMed
36.
Roth EJ, Heinemann AW, Lovell LL, Harvey RL, McGuire JR, Diaz S. Impairment and disability: their relation during stroke rehabilitation. Arch Phys Med Rehabil. 1998;79(3):329–35.CrossRefPubMed
37.
Maeshima S, Osawa A, Hayashi T, Tanahashi N. Factors Associated with prognosis of eating and swallowing disability after stroke: a study from a community-based stroke care system. J Stroke Cerebrovasc Dis. 2013;22(7):926–30.CrossRefPubMed
Metadata
Title
The association of increased drugs use with activities of daily living and discharge outcome among elderly stroke patients
Authors
Eiji Kose
Toshiyuki Hirai
Toshiichi Seki
Hiroyuki Hayashi
Publication date
01-06-2018
Publisher
Springer International Publishing
Published in
International Journal of Clinical Pharmacy / Issue 3/2018
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-018-0610-3

Other articles of this Issue 3/2018

International Journal of Clinical Pharmacy 3/2018 Go to the issue

Research Article

Impact of warfarin discharge education program on hospital readmission and treatment costs

Research Article

Implementation fidelity of a clinical medication review intervention: process evaluation

Research Article

Evaluation of a pharmacy-driven methicillin-resistant Staphylococcus aureus surveillance protocol in pneumonia

Commentary

Off-label and unlicensed prescribing in Europe: implications for patients’ informed consent and liability

Review Article

Comparative efficacy of antiepileptic drugs for patients with generalized epileptic seizures: systematic review and network meta-analyses

Research Article

Patient-pharmacist communication during a post-discharge pharmacist home visit
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits