Cardiovascular diseases and medication profile of home-visit dental treatment

• Published in: Journal of Japanese Society of Dentistry for Medically Compromised Patient Vol. 14; no. 1; pp. 45 - 51
• Main Authors: Nakajima, Takashi, Enmi, Osamu, Tani, Yuuji, Nakajima, Toshiaki, Isobe, Hiroyuki, Okada, Haruo, Katoh, Yoshio
• Format: Journal Article
• Language: English; Japanese
• Published: Japanese Society of Dentistry for Medically Compromised Patient 2005
• Subjects: cardiovascular diseases; home-visit dental treatment; pharmaceutical agent profile
• ISSN: 0918-8150; 1884-667X
• DOI: 10.11255/jjmcp1992.14.45

The purpose of the present study was to survey the prevalence of medical abnormalities, cardiovascular diseases and medication profile of home-visit dental treatment. A total of 203 patients were enrolled in this study in which 84 patients were inpatients in an intermediate care facility for the elderly (geriatric health care institution), and 119 home bound patients under home care treatment provided by the Midori Ward Dental Association in Yokohama City from April 1999 to December 2001. Mean disease association was 3.5±1.1 (mean±SD) and 2.3±1.3 for the inpatients and outpatients, respectively. The frequency of the abnormalities was greater among the inpatients at the geriatric health institution than among the home bound patients under home care treatment. Cerebrovascular, cardiovascular and metabolic disorders are important in general management for home-visit dental treatment. Among the patients with cardiovascular disease, hypertension was most prevalent (Table 1). The percentage of the subjects under medication was high: 96.4% (81) for the inpatients at the intermediate care medical facility, and 54.6% (65) for the home bound group receiving home care treatment. The patients were administered multiple pharmaceutical agents and it was mandatory to take into consideration the effects caused by combinations of medicines. On the average, the patients in the inpatient and home bound groups were identified to be taking 4.3±2.8 (mean± SD) and 3.2±3.8 different pharmaceutical agents, respectively. Cardiovascular agents administered were mainly vasodilator, hypotensive and diuretic agents (Fig. 1). Antihypertensive agents were the most commonly administered pharmaceutical agent representing 46.9% of the drugs in the intermediate medical care facility were Ca channel blockers and 31.8% in the home bound group were administered diuretics (Fig. 2). Over 70% of the patients had medical history of hypertension with circulatory complications: 71.8% (28) and 73.7% (28), respectively, mainly cerebral infarction (Fig. 3). Metabolic complications associated with hypertension were: diabetes mellitus, hyperlipemia and hyperuricemia (Fig. 4). As the number of elderly population increases, individuals with diseases also increase. Collecting and analyzing data of diseases and use of medications are through comprehensive interviews are important measures that compensate for the diagnostic process in evaluating the general state of the patients. Our study revealed the importance of a comprehensive evaluation of the patient's general state, including the information concerned with administration of medication which is indispensable for providing proper dental treatment for the home care patients.