| Abstract | Cilj istraživanja: Cilj ovog rada je bio odrediti udio lijekova koji povećavaju rizik od padova u starijih osoba koje su
smještene u domovima za starije i nemoćne te istražiti povezanost FRID-ova s negativnim kliničkim ishodima.
Ispitanici i metode: Istraživanje je provedeno kao neintervencijsko, presječno istraživanje u domovima za starije i
nemoćne osobe u tri regije Republike Hrvatske, u razdoblju od 2. kolovoza 2022. do 13. studenog 2022. godine .
Podaci o ispitanicima prikupljeni su pomoću InterRAITM validiranog upitnika temeljem razgovora sa štićenicima
domova za starije i nemoćne te medicinskih zapisa koje je ispitanik priložio prilikom ispitivanja, a uključivali su
osnovne informacije o pacijentu, funkcionalni status, povijest bolesti, propisane lijekove te podatke o hospitalizaciji i
posjeti hitnoj službi tijekom određenog razdoblja u prošlosti. Analiza FRID-ova provedena je upotrebom STOPPFall
alata.
Rezultati: U istraživanje je uključeno ukupno 225 ispitanika, prosječne životne dobi 82,52 ± 6,22 godine. Primjena
FRIDova zabilježena je kod 198 ispitanika (88%). Najveća zastupljenost primjene FRIDova bila je u Dalmaciji (n=71,
94,67%), a najmanja u Slavoniji (n=59, 78,67%). Najčešće korištene skupine FRIDova bili su benzodiazepini
(55,56%) i diuretici (47,11%), a od pojedinačnih lijekova tramadol (30,67%), furosemid (30,22%) i diazepam
(29,33%). Analiza podataka je pokazala kako postoji statistički značajna razlika u broju FRIDova ovisno o
zabilježenim padovima kod ispitanika u posljednjih 30 dana (p<0,001), prije 31-90 dana (p=0,003) i prije 91-180 dana
(p=0,020) kao i prijemu na hitnu službu unazad 90 dana (p=0,036). Utvrđeno je kako postoji statistički značajna
razlika u broju FRIDova u terapiji ispitanika ovisno o prisutnosti omaglice (p=0,020), vrtoglavice (p=0,047) i
nestabilnog hoda (p=0,003).
Zaključak: Učestalost propisivanja FRIDova kod štićenika domova za starije i nemoćne je bila vrlo visoka. Ispitanici
koji su iskusili padove, bili primljeni na hitnu službu, imali omaglicu, vrtoglavicu ili nestabilan hod su imali propisan
veći broj FRIDova. Pokazala se potreba za racionalizacijom terapije osoba u domovima za starije i nemoćne te
intervencijama poput depreskripcije. |
| Abstract (english) | Objective: The aim of this work was to determine the proportion of fall risk increasing drugs (FRIDs) in older adults
who live in nursing homes and to explore the association of FRIDs with negative clinical outcomes.
Subjects and methods: The research was conducted as a non-interventional, cross-sectional study in nursing homes
across three different regions of Croatia in the period from August 2, 2022 to November 13, 2022. Dana collection was
carried out using interRAITM Long-Term Care Facilities (LTCF) Assessment form based on interviews and medical
records available from participants. Data included basic information about the patient, functional status, medical
history, prescribed medications, hospitalizations and visits to the emergency department within a certain period in the
past. Analysis of FRIDs was performed using the STOPPFall tool.
Results: The study included total of 225 older adults, mean age being 82.52 ± 6.22 years. The use of FRIDs was
recorded in 198 subjects (88%). The highest prevalence of FRIDs use was in Dalmatia (n=71, 94.67%), and the lowest
in Slavonia (n=59, 78.67%). The most frequently used groups of FRIDs were benzodiazepines (55,56%) and diuretics
(47,11%). Of the individual drugs categorized as FRIDs, the most commonly used were tramadol (30,67%),
furosemide (30,22%) and diazepam (29,33%). Data analysis showed that there is a statistically significant difference in
the number of FRIDs depending on the recorded falls in the last 30 days (p<0.001), 31-90 days ago (p=0.003) and 91-
180 days ago (p =0.020) as well as admission to the emergency department in the past 90 days (p=0.036). It was found
that there is a statistically significant difference in the number of FRIDs depending on the presence of dizziness
(p=0.020), vertigo (p=0.047) and unsteady gait (p=0.003).
Conclusion: The study found high prevalence of FRID prescriptions among older residents in nursing homes in
Croatia. Those who had experienced falls, been admitted to the emergency department, or had symptoms such as
dizziness, vertigo, and unsteady gait were prescribed a higher number of FRIDs. The results highlight the need to
rationalize therapy for older adults in nursing homes and to consider interventions such as deprescribing inappropriate
FRIDs. |
