Reduction of inappropriate medications among older nursing-home residents: a nurse-led, pre/post-design, intervention study

Blozik, Eva; Born, Andreas M; Stuck, Andreas E; Benninger, Ulrich; Gillmann, Gerhard; Clough-Gorr, Kerri M (2010). Reduction of inappropriate medications among older nursing-home residents: a nurse-led, pre/post-design, intervention study. Drugs & aging, 27(12), pp. 1009-1017. Auckland (NZ): Adis International 10.2165/11584770-000000000-00000

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Background: Medication-related problems are common in the growing population of older adults and inappropriate prescribing is a preventable risk factor. Explicit criteria such as the Beers criteria provide a valid instrument for describing the rate of inappropriate medication (IM) prescriptions among older adults. Objective: To reduce IM prescriptions based on explicit Beers criteria using a nurse-led intervention in a nursing-home (NH) setting. Study Design: The pre/post-design included IM assessment at study start (pre-intervention), a 4-month intervention period, IM assessment after the intervention period (post-intervention) and a further IM assessment at 1-year follow-up. Setting: 204-bed inpatient NH in Bern, Switzerland. Participants: NH residents aged ≥60 years. Intervention: The intervention included four key intervention elements: (i) adaptation of Beers criteria to the Swiss setting; (ii) IM identification; (iii) IM discontinuation; and (iv) staff training. Main Outcome Measure: IM prescription at study start, after the 4-month intervention period and at 1-year follow-up. Results: The mean±SD resident age was 80.3±8.8 years. Residents were prescribed a mean±SD 7.8±4.0 medications. The prescription rate of IMs decreased from 14.5% pre-intervention to 2.8% post-intervention (relative risk [RR] = 0.2; 95% CI 0.06, 0.5). The risk of IM prescription increased nonstatistically significantly in the 1-year follow-up period compared with post-intervention (RR = 1.6; 95% CI 0.5, 6.1). Conclusions: This intervention to reduce IM prescriptions based on explicit Beers criteria was feasible, easy to implement in an NH setting, and resulted in a substantial decrease in IMs. These results underscore the importance of involving nursing staff in the medication prescription process in a long-term care setting.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic

UniBE Contributor:

Blozik, Eva; Stuck, Andreas; Gillmann, Gerhard and Clough, Kerri

ISSN:

1170-229X

Publisher:

Adis International

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:09

Last Modified:

11 Aug 2015 13:57

Publisher DOI:

10.2165/11584770-000000000-00000

PubMed ID:

21087070

Web of Science ID:

000285534800006

BORIS DOI:

10.7892/boris.1016

URI:

https://boris.unibe.ch/id/eprint/1016 (FactScience: 201677)

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