原创力文档high risk prescribing in older adults prevalence, clinical and economic implications and potential for intervention at the population level高风险处方老年人发病率、临床和经济影响和干预的潜在人口水平.pdfVIP
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high risk prescribing in older adults prevalence, clinical and economic implications and potential for intervention at the population level高风险处方老年人发病率、临床和经济影响和干预的潜在人口水平
Gnjidic et al. BMC Public Health 2013, 13:115
/1471-2458/13/115
STUDY PROTOCOL Open Access
High risk prescribing in older adults: prevalence,
clinical and economic implications and potential
for intervention at the population level
1,2,3,4* 2,4,5 1 1,2 6
Danijela Gnjidic , David G Le Couteur , Sallie-Anne Pearson , Andrew J McLachlan , Rosalie Viney ,
Sarah N Hilmer3,4, Fiona M Blyth2,4, Grace Joshy7 and Emily Banks7,8
Abstract
Background: High risk prescribing can compromise independent wellbeing and quality of life in older adults. The
aims of this project are to determine the prevalence, risk factors, clinical consequences, and costs of high risk
prescribing, and to assess the impact of interventions on high risk prescribing in older people.
Methods: The proposed project will utilise data from the 45 and Up Study, a large scale cohort of 267,153 men
and women aged 45 and over recruited during 2006–2009 from the state of New South Wales, Australia linked to a
range of administrative health datasets. High risk prescribing will be assessed using three indicators: polypharmacy
(use of five or more medicines); Beers Criteria (an explicit measure of potentially inappropriate medication use); and
Drug Burden Index (a pharmacologic dose-dependent measure of cumulative exposure to anticholinergic and
sedative medicines). Individual risk factors from the 45 and Up Study questionnaire, and health system
characteristics from health datasets that are associated with the likelihood of high risk prescribing will be identified.
The main outcome measures will include hospitalisation (first admission to hospital, total days in hospital,
cause-specific hospitalisation); admissio
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