Table 3.
Use of potentially inappropriate medications according to the NORGEP-NH criteria in the nursing home residents (n = 103) in the urban and rural study locations.
| Total | Urban 1 | Rural 2 | p between Locations | ||||
|---|---|---|---|---|---|---|---|
| NH-NORGEP Items | n = 103 | n = 70 | n = 33 | ||||
| A: Single substance criteria; Regular use should be avoided | n | % | n | % | n | % | |
| 1. Combination analgesic codeine/paracetamol 1 | 1 | 0.9 | 0 | 0.0 | 1 | 3.0 | 0.320 |
| 2. Tricyclic antidepressants (TCAs) | 1 | 0.9 | 0 | 0.0 | 1 | 3.0 | 0.320 |
| 3. Non-steroidal anti-inflammatory drugs (NSAIDs) | 1 | 0.9 | 0 | 0.0 | 1 | 3.0 | 0.320 |
| 4. First-generation antihistamines | 2 | 1.9 | 0 | 0.0 | 2 | 6.1 | 0.101 |
| 5. Diazepam | 1 | 0.9 | 1 | 1.4 | 0 | 0.0 | 1.000 |
| 6. Oxazepam (>30 mg/24 h) | 1 | 0.9 | 0 | 0.0 | 1 | 3.0 | 0.320 |
| 7. Zopiclone (>5 mg/24 h) 2 | 4 | 3.9 | 1 | 1.4 | 3 | 9.1 | 0.096 |
| 8. Nitrazepam | 2 | 1.9 | 0 | 0.0 | 2 | 6.1 | 0.101 |
| 9. Flunitrazepam | 0 | - | 0 | - | 0 | - | - |
| 10. Chlometiazole | 6 | 5.8 | 6 | 8.6 | 0 | 0.0 | 0.173 |
| 11. Regular use of hypnotics | 24 | 23.3 | 16 | 22.9 | 8 | 24.2 | 0.877 |
| Any single substances | 29 | 28.2 | 18 | 25.7 | 11 | 33.3 | 0.484 |
| B: Combination criteria; Combinations to avoid | |||||||
| 12. Warfarin + NSAIDs | 0 | - | 0 | - | 0 | - | - |
| 13. Warfarin + SSRIs/SNRIs | 3 | 2.9 | 0 | 0.0 | 3 | 9.1 | 0.031 |
| 14. Warfarin + ciprofloxacin/ofloxacin/erythromycin/clarithromycin | 0 | - | 0 | - | 0 | - | - |
| 15. NSAIDs/coxibs + ACE inhibitors/AT2 antagonists | 1 | 0.9 | 0 | 0.0 | 1 | 3.0 | 0.320 |
| 16. NSAIDs/coxibs + diuretics | 0 | - | 0 | - | 0 | - | - |
| 17. NSAIDs/coxibs + glucocorticoids | 0 | - | 0 | - | 0 | - | - |
| 18. NSAIDs/coxibs + SSRI/SNRIs | 0 | - | 0 | - | 0 | - | - |
| 19. ACE inhibitors/AT2 antagonists + potassium or potassium-sparing diuretics | 2 | 1.9 | 2 | 2.9 | 0 | 0.0 | 1.000 |
| 20. β-blocker agents + cardioselective calcium antagonists | 0 | - | 0 | - | 0 | - | - |
| 21. Erythromycin or clarithromycin + statin | 0 | - | 0 | - | 0 | - | - |
| 22. Bisphosphonate + proton pump inhibitors | 1 | 0.9 | 0 | 0.0 | 1 | 3.0 | 0.320 |
| 23. Concomitant use of three or more psychotropics | 8 | 7.8 | 4 | 5.7 | 4 | 12.1 | 0.265 |
| 24. Tramadol + SSRIs | 0 | - | 0 | - | 0 | - | - |
| 25. Metoprolol + paroxetine/fluoxetine/bupropion | 0 | - | 0 | - | 0 | - | - |
| 26. Metformin + ACE inhibitor/AT2 antagonists + diuretics | 2 | 1.9 | 2 | 2.9 | 0 | 0.0 | 1.000 |
| Any combinations to avoid | 16 | 15.5 | 7 | 10.0 | 9 | 18.2 | 0.039 |
| C: Deprescribing criteria; Need for continued use should be reassessed | |||||||
| 27. Antipsychotics (incl. “atypical” substances) | 12 | 15.5 | 9 | 18.6 | 3 | 9.1 | 0.747 |
| 28. Antidepressants | 27 | 26.2 | 16 | 22.9 | 11 | 33.3 | 0.259 |
| 29. Urologic spasmolytics | 1 | 0.9 | 1 | 1.4 | 0 | 0.0 | 1.000 |
| 30. Anticholinesterase inhibitors | 1 | 0.9 | 1 | 1.4 | 0 | 0.0 | 1.000 |
| 31. Medicines lowering blood pressure * | - | - | - | - | - | - | - |
| 32. Bisphosphonates | 4 | 3.9 | 0 | 0.0 | 4 | 12.1 | 0.009 |
| 33. Statins | 5 | 4.8 | 1 | 1.4 | 4 | 12.1 | 0.035 |
| 34. Any preventive medicine * | - | - | - | - | - | - | - |
| Any deprescribing item | 46 | 44.7 | 26 | 37.1 | 20 | 60.6 | 0.034 |
| Any NORGEP-NH criteria | 58 | 56.3 | 35 | 50.0 | 23 | 69.7 | 0.088 |
* Not applicable. 1 four nursing homes, 2 two nursing homes.