title: Medication use and potentially inappropriate medications in those with limited prognosis living in residential aged care.
abstract: OBJECTIVE
  To compare the prevalence in residential aged care (RAC) of preventative and potentially inappropriate medications (PIMs) in those who died within 12 months versus those alive after 12 months.
  
  
  METHODS
  Firstly, a cross-sectional survey of 6196 people living in RAC in Auckland. Secondly, a research physician searched electronic hospital records in one District Health Board for a sub-sample (n = 222) of these residents. Classes of medications and dates of death were obtained from the Ministry of Health databases. Those who died versus those alive at 12 months were compared.
  
  
  RESULTS
  Over half of the 6196 participants received antihypertensives and/or antiplatelet agents. Cardiovascular preventative medications were significantly more common in those who died within 12 months. Seventy percent in high-level care received psychotropics. PIMs were commonly used.
  
  
  CONCLUSIONS
  Use of preventative medications is common in RAC, especially during the last year of life. Psychotropics are very commonly used, despite being potentially inappropriate.
authors.affiliation: Freemasons' Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Claire Patricia
authors.initials: CP
authors.lastname: Heppenstall
authors.affiliation: Freemasons' Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Joanna B
authors.initials: JB
authors.lastname: Broad
authors.affiliation: School of Nursing, Freemasons' Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Michal
authors.initials: M
authors.lastname: Boyd
authors.affiliation: Aged Residential Care, Inpatient Pharmacy, Waitemata District Health Board, Auckland, New Zealand.
authors.forename: Joanna
authors.initials: J
authors.lastname: Hikaka
authors.affiliation: Freemasons' Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Xian
authors.initials: X
authors.lastname: Zhang
authors.affiliation: School of Pharmacy, University of Auckland, Auckland, New Zealand.
authors.forename: Julia
authors.initials: J
authors.lastname: Kennedy
authors.affiliation: Freemasons' Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.|Department of Geriatric Medicine, Waitemata District Health Board, Auckland, New Zealand.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Connolly
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017723:Drug Utilization Review; D057286:Electronic Health Records; D005260:Female; D016330:Frail Elderly; D019538:Health Care Surveys; D006707:Homes for the Aged; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control; D008017:Life Expectancy; D008297:Male; D009520:New Zealand; D009735:Nursing Homes; D019338:Polypharmacy; D000067561:Potentially Inappropriate Medication List; D011314:Preventive Health Services / Q000379:methods*; D011379:Prognosis; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D002317:Cardiovascular Agents; D011619:Psychotropic Drugs
keywords: frail elderly; homes for the aged; inappropriate prescribing; palliative care; polypharmacy