Background no studies have examined the impact of residential medication management review (RMMR, a 24-year government subsidised comprehensive medicines review program) in Australian residential aged care facilities (RACFs) on hospitalisation or mortality. Objective to examine associations between RMMR provision in the 6–12 months after RACF entry and the 12-month risk of hospitalisation and mortality among older Australians in RACFs. Design retrospective cohort study. Subjects individuals aged 65–105 years taking at least one medicine, who entered an RACF in three Australian states between 1 January 2012 and 31 December 2015 and spent at least 6 months in the RACF (n = 57,719). Methods Cox regression models estimated adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for associations between RMMR provision and mortality. Adjusted subdistribution hazard ratios were estimated for associations between RMMR provision and next (i) emergency department (ED) presentation or unplanned hospitalisation or (ii) fall-related ED presentation or hospitalisation. Results there were 12,603 (21.8%) individuals who received an RMMR within 6–12 months of RACF entry, of whom 22.2% (95%CI 21.4–22.9) died during follow-up, compared with 23.3% (95%CI 22.9–23.7) of unexposed individuals. RMMR provision was associated with a lower risk of death due to any cause over 12-months (aHR 0.96, 95%CI 0.91–0.99), but was not associated with ED presentations or hospitalisations for unplanned events or falls. Conclusions provision of an RMMR in the 6–12 months after RACF entry is associated with a 4.4% lower mortality risk over 12-months but was not associated with changes in hospitalisations for unplanned events or falls.

中文翻译：

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提供全面的药物审查与降低老年护理机构居民的死亡风险相关：一项回顾性队列研究

背景 没有研究检查澳大利亚住宅老年护理机构 (RACF) 的住宅药物管理审查（RMMR，一项为期 24 年的政府补贴综合药物审查计划）对住院或死亡率的影响。目的检查 RACF 进入后 6-12 个月内提供 RMMR 与 RACF 中老年澳大利亚人 12 个月住院和死亡风险之间的关联。设计回顾性队列研究。受试者年龄在 65-105 岁之间，至少服用一种药物，他们在 2012 年 1 月 1 日至 2015 年 12 月 31 日期间进入澳大利亚三个州的 RACF，并在 RACF 中度过了至少 6 个月（n = 57,719）。方法 Cox 回归模型估计了调整后的风险比 (aHRs) 和 95% 置信区间 (CIs)，用于 RMMR 供应和死亡率之间的关联。针对 RMMR 提供与下一次 (i) 急诊 (ED) 就诊或计划外住院或 (ii) 跌倒相关 ED 就诊或住院之间的关联，估计了调整后的子分布风险比。结果 有 12,603 名 (21.8%) 人在 RACF 进入后 6-12 个月内接受了 RMMR，其中 22.2% (95%CI 21.4-22.9) 在随访期间死亡，而 23.3% (95%CI 22.9- 23.7) 未暴露的个人。提供 RMMR 与 12 个月内因任何原因导致的死亡风险降低相关（aHR 0.96, 95%CI 0.91-0.99），但与急诊就诊或意外事件或跌倒住院无关。结论 RACF 进入后 6-12 个月内提供 RMMR 与 4.