Prescription of Ninjin'yoeito, A Japanese Kampo Medicine, in Relation to Levels of Long-Term Care Needs or Disabilities in Older Adults: A Cross-Sectional Study.

INTRODUCTION

Ninjin'yoeito, a Japanese Kampo medicine, is expected to be effective for frailty, but its utilization in Japanese clinical practice is unknown. Thus, this study aimed to characterize older adults who were prescribed ninjin'yoeito in terms of long-term care (LTC) needs, physical and cognitive disabilities, and diagnoses.

METHODS

We conducted a population-based cross-sectional study using medical and LTC claims data for adults aged ≥75 years in 2019 in Hachioji City, Tokyo, Japan. LTC needs levels were classified into four categories: independent (including no certification), support level 1 or 2, care level 1 or 2, and care levels 3 to 5. Disability levels were categorized into nine groups based on the combination of levels of physical disability and cognitive impairment, which were assessed using nationally standardized measures at LTC needs certification. Multivariable logistic regression analyses were performed to evaluate the associations between ninjin'yoeito prescriptions during a three-month period and LTC needs or disability levels, adjusting for age and sex. We described the differences in the frequencies of International Classification of Diseases, Tenth Revision (ICD-10)-based diagnoses between participants with and without ninjin'yoeito prescriptions.

RESULTS

The study included 59,133 participants (median age, 80 years; 58.6% female). Ninjin'yoeito prescription prevalence was 0.22% (n = 130). Participants at support level 1 or 2, those at care level 1 or 2, and those who were independent living and had mild cognitive impairment were more likely to be prescribed ninjin'yoeito (adjusted odds ratio, 2.68; 95% confidence interval, 1.70-4.21; 1.91, 1.18-3.10; and 3.24, 2.04-5.15, respectively). Participants prescribed ninjin'yoeito were more likely to have diagnoses, including symptoms and signs related to food and fluid intake, malaise and fatigue, and dorsalgia.

CONCLUSIONS

We identified the characteristics of community-dwelling older adults prescribed ninjin'yoeito. Our results may suggest that ninjin'yoeito was generally prescribed to older adults with frailty, within the indications of this formulation on the Japanese label.