Relationship Between Frailty and Drug Burden Index in Older Hospitalized Patients

In a super-aging society, understanding the prescription status of drug burden index (DBI) drugs that have anticholinergic and sedative effects in patients with frailty to consider proper medical intervention and promote appropriate drug use for older adults is important. This study evaluated the association between frailty and the use of DBI drugs in older hospitalized patients using hospital electronic medical records.

This cross-sectional study included patients admitted to the Kameda Medical Center between October 1, 2016 and October 31, 2017. Patients with a Barthel Index of <90 or Mini-Mental State Examination score of <18 or otherwise were classified into the frailty and non-frailty groups, respectively. DBI drugs fall into nine categories based on previous studies, and 162 drugs marketed in Japan were included. Patients using DBI drugs were considered DBI drug users; otherwise, patients were considered DBI drug non-users. Comparisons of the DBI drug proportions in both groups were performed using logistic regression analysis while adjusting for patient background factors and calculating the adjusted odds ratios and 95% confidence intervals.

The proportion of DBI drug users was significantly lower in the frailty group compared to the non-frailty group (adjusted odds ratio=0.32, 95% confidence interval=0.24-0.42, p<0.001).

Hospitalized older patients with frailty in Japan may be associated with a lower risk of DBI drug use and may use drugs with caution. In clinical practice, drug treatment for older patients may be implemented in consideration of various patient backgrounds, including frailty.