Impact of educational intervention on prescribing inappropriate medication to elderly nursing homes residents

Ilić, Dušan; Bukumirić, Zoran; Janković, Slobodan M.

doi:10.2298/sarh1504174i

Cited by 16 publications

(44 citation statements)

References 31 publications

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“…is vague, such as formal versus informal. The aim of this study was to evaluate the effectiveness of a specific form of staff education and its ability to increase appropriate prescribing in a cluster of nursing homes (Ilic et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

“…This study is a nonrandomized controlled before-and-after trial of educational intervention (Ilic et al, 2015). The quality of this study is strong (Downs & Black, 1998), with level three evidence per Mazurek & Fineout-Overhold (2011).…”

Section: Methods Of Data Collection Sample and Settingmentioning

confidence: 95%

“…This study was conducted in three phases, including a three-month phase of recording prescribing practices, one-month phase of educational intervention, and a three-month phase of recording and analyzing prescribing practices at a six-month follow-up (Ilic et al, 2015). The intervention was two-faceted targeting physicians and residents.…”

Section: Ilicmentioning

confidence: 99%

“…The intervention was two-faceted targeting physicians and residents. For physicians, one-hour lectures were provided by a medical doctor who had a Master of Science in pharmacology about the pharmacokinetics and pharmacodynamics of drugs in the elderly, the Beers, START, and STOPP criteria, and screening tools to alert physicians to the right treatment (Ilic et al, 2015).…”

Section: Ilicmentioning

confidence: 99%

“…Separate brochures were provided to physicians and residents with the identical content that they were each provided in lectures (Ilic et al, 2015).…”

Section: Ilicmentioning

confidence: 99%

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The role of the nurse practitioner in promoting a reduction in the causes and outcomes of problematic polypharmacy among nursing home residents in British Columbia

Jassar¹

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Problematic polypharmacy is an ongoing issue for older adults throughout Canada, and specifically among nursing home residents (Maher, Hanion, & Hajjar, 2013). Despite interventions that are currently in place in British Columbia (BC) to reduce the causes and outcomes of this issue, problematic polypharmacy continues to pose a risk for residents among BC nursing homes. This integrative review asks how nurse practitioners (NPs) can best promote a reduction in the causes and outcomes of problematic polypharmacy among residents in BC nursing homes.The background information of this project outlines the concept of problematic polypharmacy and the prevalence of contributing factors and outcomes. Nursing home demographics are also highlighted to demonstrate the risk this population faces to the causes and outcomes of problematic polypharmacy, and the subsequent effect this issue has on the health care system. Furthermore, the background provides an overview of the concept role overlap which exists between health care professionals in order to demonstrate how multiple health care professionals may share roles or parts of roles in reducing the causes and outcomes of problematic polypharmacy. Barriers faced by staff are also examined.Through a comprehensive review of the literature and critical appraisal, nine articles are found to address the research question. Key interventions that specifically demonstrate effectiveness in reducing causes and outcomes of problematic polypharmacy in the context of nursing homes emerged. These interventions are put forth as recommendations for NP practice and include: medication reviews while screening for inappropriate medications by using the Beers Criteria, computerized clinical decision support systems (CCDSS), and the Cockcroft Gault Score; assessing functional status for changes to assure instances of problematic 3 polypharmacy are not missed by using the Minimum Data Set -Activity of Daily Living (MDS-ADL) scale; education targeted for all staff members to detect, prevent, and manage problematic polypharmacy; multidisciplinary team meetings to facilitate a collaborative approach in reducing problematic polypharmacy and case conferences to provide resident-centered care.An important finding is that most interventions require participation from two or more health professionals, highlighting the concept of role overlap and the necessity of a multidisciplinary approach. In light of NP practice, this provides insight surrounding how NPs can influence and encourage other staff members to sustain their roles and overcome barriers for an ultimate reduction in the causes and outcomes of problematic polypharmacy with implications for practice, policy, education, and research.

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Section: Resultsmentioning

confidence: 99%

Section: Methods Of Data Collection Sample and Settingmentioning

confidence: 95%

Section: Ilicmentioning

confidence: 99%

Section: Ilicmentioning

confidence: 99%

“…Separate brochures were provided to physicians and residents with the identical content that they were each provided in lectures (Ilic et al, 2015).…”

Section: Ilicmentioning

confidence: 99%

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The role of the nurse practitioner in promoting a reduction in the causes and outcomes of problematic polypharmacy among nursing home residents in British Columbia

Jassar¹

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Interventions to improve the appropriate use of polypharmacy for older people

Rankin

Cadogan

Patterson³

et al. 2018

Cochrane Database of Systematic Reviews

342

408

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A narrative review of evidence to guide deprescribing among older adults

Aoshima

Yabuki

et al. 2021

J of Gen and Family Med

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Potentially inappropriate prescription and polypharmacy are well‐known risk factors for morbidity and mortality among older adults. However, recent systematic reviews have failed to demonstrate the overall survival benefits of deprescribing. Thus, it is necessary to synthesize the current evidence to provide a practical direction for future research and clinical practice. This review summarizes the existing body of evidence regarding deprescribing to identify useful intervention elements. There is evidence that even simple interventions, such as direct deprescribing targeted at risky medications and explicit criteria‐based approaches, effectively reduce inappropriate prescribing. On the other hand, if the goal is to improve clinical outcomes such as hospitalization and emergency department visits, patient‐centered multimodal interventions such as a combination of medication review, multidisciplinary collaboration, and patient education are likely to be more effective. We also consider the opportunities and challenges for deprescribing within the Japanese healthcare system.

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Impact of educational intervention on prescribing inappropriate medication to elderly nursing homes residents

Abstract: Simple, but well targeted educational interventions may improve polypharmacy and decrease inappropriate prescribing rate, contributing to a better care of elderly patients in nursing homes.

Cited by 16 publications

References 31 publications

The role of the nurse practitioner in promoting a reduction in the causes and outcomes of problematic polypharmacy among nursing home residents in British Columbia

The role of the nurse practitioner in promoting a reduction in the causes and outcomes of problematic polypharmacy among nursing home residents in British Columbia

Interventions to improve the appropriate use of polypharmacy for older people

A narrative review of evidence to guide deprescribing among older adults

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