背景:家庭药物审查(HMR)对接受长期家庭老年护理服务的个人的长期健康结果的影响尚不清楚。
目的:为了检查HMR供应与住院之间的关系,接受长期居家养老护理服务的老年人的长期护理机构(LTCF)准入和死亡率。
方法:这项回顾性队列研究包括来自澳大利亚三个州的65-105岁的个体,他们在2013年至2017年期间获得了家庭老年护理服务。使用倾向得分匹配,HMR接受者(n=1530)与未接受HMR的个体(n=1530)相匹配。使用多变量回归模型估计HMR提供和结果之间的关联。
结果:在中位414天(四分位距217-650)的随访中,HMR拨备与非计划性事件住院无关(分分布风险比(sHR)1.04,95CI0.96-1.14),跌倒相关住院(sHR0.97,95CI0.83-1.13),LTCF条目(sHR0.97,95CI0.83-1.13),或全因死亡率(校正后HR0.86,95CI0.72-1.01)。
结论:在接受长期居家养老护理服务的一群老年人中,计划外住院没有差异,falls,与未接受HMR的患者相比,有HMR的患者观察到LTCF进入或死亡。
BACKGROUND: The impact of Home Medicines Reviews (HMRs) on long-term health outcomes among individuals receiving long-term in-home aged care services is unknown.
OBJECTIVE: To examine associations between HMR provision and hospitalization, long-term care facility (LTCF) entry and mortality among older people receiving long-term in-home aged care services.
METHODS: This retrospective cohort study included individuals aged 65-105 years from three Australian states who accessed in-home aged care services between 2013 and 2017. Using propensity score matching, HMR recipients (n = 1530) were matched to individuals who did not receive an HMR (n = 1530). Associations between HMR provision and outcomes were estimated using multivariable regression models.
RESULTS: Over a median of 414 days (interquartile range 217-650) of follow-up, HMR provision was not associated with hospitalizations for unplanned events (subdistribution hazard ratio (sHR) 1.04, 95%CI 0.96-1.14), falls-related hospitalizations (sHR 0.97, 95%CI 0.83-1.13), LTCF entry (sHR 0.97, 95%CI 0.83-1.13), or all-cause mortality (adjusted HR 0.86, 95%CI 0.72-1.01).
CONCLUSIONS: In a cohort of older people receiving long-term in-home aged care services, no differences in unplanned hospitalizations, falls, LTCF entry or mortality were observed those with HMRs compared to those that did not receive an HMR.