Gerontologie+ Geriatrie - SGG-SSG

present the results about the test-retest and inter-rater reliability of the
interRAI LTCF instrument; 3. to illustrate the characteristics of NH residents
at study entry.
Methods. A 12-months prospective cohort study was conducted in 57
NH in 7 EU countries (Czech Republic, England, Finland, France, Germany,
Italy, The Netherlands) and 1 non-EU country (Israel). Weighted
kappa coefficients were used to evaluate the reliability of interRAI LTCF
items.
Results. Mean age of 4156 residents entering the study was 83.4±9.4
years, 73% were female. ADL disability and cognitive impairment was
observed in 81.3% and 68.0% of residents, respectively. Clinical complexity
of residents was confirmed by a high prevalence of behavioral
symptoms (27.5% of residents), falls (18.6%), pressure ulcers (10.4%), pain
(36.0%) and urinary incontinence (73.5%). Overall, 197 of the 198 the
items tested met or exceeded standard cut-offs for acceptable test-retest
and interrater reliability after translation into the target languages.
Conclusion. The interRAI LTCF appears to be a reliable instrument. It
enables the creation of databases that can be used to govern the provision
of long-term care across different health systems in Europe, to
answer relevant research and policy questions and to compare characteristics
of NH residents across countries, languages and cultures.
0102
Potentially inappropriate medication use in older NH residents in
EUROPE: Results of the EU SHELTER project
*D. Fialová 1 , J. Reissigová 1 , G. Onder 2 , E. Topinková 1 , H. Finne-Soveri 3 , J. Gindin
4 , I. Carpenter 5 , R. Bernabei 2
1
Charles University, Department of Geriatrics and Gerontology, Prague,
Czech Republic, 2 Centro Medicina dell’Invecchiamento, Università Cattolica
Sacro Cuore, Geriatric medicine, Rome, Italien, 3 National Institute for Health
and Welfare, Helsinki, Finland, 4 Laboratory of Research in Geriatrics and
Gerontology, University of Haifa, Haifa, Israel, 5 Centre for Health Services
Studies, University of Kent , Kent, Großbritannien
Background. Use of potentially inappropriate medications (PIMs) in older
patients is common and accompanied with prescribing habits. The
aim of analyses was to determine exposition and prescribing patterns in
PIM use in nursing home (NH) residents in Europe.
Methods. We analyzed data of 4156 NH patients (65+) participating in
the EU SHELTER project (7th EC FP, 2008–2011, 7 EU countries (Italy
– IT, Czech Republic – CZ, England – EN, Finland – FIN, France – FR,
Germany – GER, the Netherlands – NL) and Israel – ISR). Patients were
prospectively assessed (Sep – Dec 2009) using standardized interRAI-
LTCF instrument (www.inter-rai.org). The prevalence of PIMs was determined
using expert panels’ criteria published till 2012 year. Pearson
c2-statistics was applied to test homogeneity across study samples and
Cochran-Mantel-Haenszel test to control results for age, gender and
polypharmacy.
Results. 40.5% of NH residents (mean age 83.5±9.4 yrs, 73% of women)
used at least 1 PIM (GER 28.0%, FIN 30.0%, IT 35.1%, EN 41.7%, NL
44.2%, ISR 51.3%, CZ 54.1% and FR 62.9%). Beers’s criteria documented
lower prevalence: 16.6% [8.7% in GER 31.6% in FR (with extensive use
of obsolete meds, e.g. meprobamate in 12%)]. Several country-specific
prescribing habits were found (p5 mg/d (FR CZ), zopiclon >3.75 mg/d
(GER, ISR, FIN), temazepam >15 mg/day (FIN), vasoacting agents (CZ),
ticlopidin, lorazepam 3 mg/day, phenobarbital (IT), sotalol (NL) and
brotizolam >0,125 mg/day (ISR).
Conclusions. 40% of older NH residents in Europe use at least one PIM
with substantial differences across countries. Rigorous outcome research
is necessary to explain if some PIMs have positive therap. value.
0103
The relationship between quality of care and care practice organization
in European long-term care facilities
*H. van der Roest 1 , D.H.M. Frijters 1
1
EMGO Institute for Health and Care Research, Department of Nursing
Home Medicine, VU University Medical Center, Amsterdam, Niederlande
Background. Care practice in long-term care differs across countries
and facilities. Until recently no international study in Europe has been
executed to explore intercultural differences in long-term care organization
and services. In the SHELTER study we explored differences between
European long-term care facilities and the relationship between
country specific organizational characteristics of long-term health care
and quality of care.
Methods. The SHELTER study had a longitudinal design. Data collection
took place in 59 long-term care facilities in eight countries: the
Czech Republic, the United Kingdom, Germany, Finland, France, Israel,
Italy, and the Netherlands. Trained nurses collected data at baseline,
after six, and 12 months. 4156 patients were included. Patient health
status was comprehensively assessed with the interRAI-LTCF. From the
interRAI-LTCF quality indicators (QIs), case-mix indexes, and validated
scales on patient functioning can be calculated. Reasons for patient
discharge were also collected. At baseline additional information on
structure and process characteristics (e.g. size, staff formation, education)
of the participating long-term care facilities was gathered with the
use of a specially designed form.
Results. Preliminary results on baseline data already showed significant
inverse relationships between the ratio of licensed nurses and the prevalence
of depression (r=−0.37, p=0.01), and between the ratio of nurse
aides and antipsychotic use (r=−0.45, p