Multiple turns: Potential risk factor for falls on the way to the toilet

Abstract

Of the patients, 66.2% were female, and the age was 85.4 6.0 years. We surveyed prescribed drugs and provided home medical care services at the first home visit by a physician and again 3 months later. The use of home care services did not change for 3 months. Differences were evaluated using the t-test for continuous variables, and the χ-test for percentages. We defined polypharmacy as prescription of five or more medications, and potentially inappropriate medications (PIM) according to the Screening Tool for Older Persons’ appropriate Prescriptions for Japanese (STOPP-J). The study was approved by the ethics review board of the Graduate School of Medicine, The University of Tokyo (11391-[3]). The number of prescribed medications per patient was 4.3 3.2 at the first home visit by a physician, and 4.7 3.1 3 months later (P = 0.01, paired t-test). The number of patients prescribed PIM was 36 (45.0%) at the commencement of the home visit, and 38 (47.5%) after 3 months. The most frequently prescribed therapeutic class of PIM was hypnotics, followed by diuretics. The number of PIM per patient was 0.73 0.94 at the first home visit by a physician, and 0.73 0.90 3 months later (not significant). We compared the non-polypharmacy group and polypharmacy group at the first home visit (Table 1). The polypharmacy group had a significantly higher proportion of nurse home visits. We also compared patients with an increased number of drugs at 3 months after the first home visit by a physician and those without an increase. The number of prescribed drugs in the group of patients with an increased number of medications at 3 months after the first home visit by a physician was significantly lower at the first home visit than the group of patients without an increase. The polypharmacy group used home visits by nurses more frequently compared with the non-polypharmacy group. We speculated that the increased number of prescribed drugs after 3 months was related to medication non-compliance, the number of comorbidities and adverse drug reactions. The present study was carried out at three clinics in Tokyo. To clarify the effects of home medical care services on drug prescriptions, we should investigate a larger population of patients receiving home medical care services.