The edition · Geriatrics
Half of US nursing home residents on opioids also took a gabapentinoid or sedative
National nursing home data on opioid co-prescribing, a geriatric framework for GLP-1-based obesity drugs, a pragmatic trial for elder abuse and self-neglect, fracture residents on fall-risk drugs but rarely on bisphosphonates, and an FDA action on a denosumab biosimilar.
The edition in brief
In 135,347 long-stay US nursing home residents in 2019, 24.0% had an opioid prescription and 11.4% were long-term users; 52.0% of opioid users also took a potentiator, most often a gabapentinoid, then benzodiazepines and Z-drugs. A cross-sectional study of 192,118 nursing home residents with a recent fracture found 72.8% were on drugs linked to injurious falls but only 4.2% on an oral bisphosphonate. A pragmatic randomised trial of 114 older adults at risk of or experiencing abuse or self-neglect found the community RISE programme improved life satisfaction, stress, self-efficacy and support over six months compared with consultation and referral alone. A JAGS framework on GLP-1-based obesity drugs in older adults stresses lean-mass loss, dehydration, malnutrition and aspiration risk, and pairs prescribing with resistance training, protein and functional monitoring. The FDA database lists a supplement on 23 October for Jubbonti, a denosumab biosimilar.
Opioid co-prescribing with potentiators was common in long-stay nursing home residents
At each care home medicine review, look for opioids combined with gabapentinoids or sedatives and deprescribe where possible.
A community programme for elder abuse and self-neglect improved wellbeing measures over six months
Structured community support for older adults facing abuse or self-neglect can improve wellbeing; keep safeguarding duties in place alongside it.
After a fracture, nursing home residents were far likelier to be on fall-risk drugs than bisphosphonates
After a fracture in a care home resident, start bone protection and review fall-risk drugs at the same visit.
FDA database lists a supplement for Jubbonti, a denosumab biosimilar
Note the Jubbonti supplement, check the label for what changed, and keep denosumab follow-on plans in place.
Check lying and standing blood pressure in anyone who falls
Do a lying and standing blood pressure in every falls assessment.
GLP-1-based obesity drugs in older adults: pair them with protein, resistance training and function checks
When prescribing GLP-1-based obesity drugs to older adults, monitor function and add resistance training and protein, not just weight checks.
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