Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Am Med Dir Assoc. 2014 Dec;15(12):892-8. doi: 10.1016/j.jamda.2014.04.002. Epub 2014 May 10.

Education to reduce potentially harmful medication use among residents of assisted living facilities: a randomized controlled trial.

Author information

  • 1Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Helsinki, Finland. Electronic address: kaisu.pitkala@helsinki.fi.
  • 2Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Helsinki, Finland; City of Kouvola, Services for the Aged, Kouvola, Finland.
  • 3Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Helsinki, Finland.
  • 4Social Services and Health Care Department, City of Helsinki, Finland.
  • 5Head of the Ageing and Services, National Institute for Health and Welfare, Helsinki, Finland.
  • 6Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
  • 7Unit of Primary Health Care, Helsinki University Central Hospital, Department of General Practice, University of Helsinki, Helsinki, Finland; Geriatric Unit, Department of Internal Medicine, University of Helsinki, Helsinki, Finland.

Abstract

OBJECTIVES:

The objectives of this study were (1) to investigate the effect of nurse training on the use of potentially harmful medications; and (2) to explore the effect of nurse training on residents' health-related quality of life (HRQoL), health service utilization, and mortality.

DESIGN:

A randomized controlled trial.

SETTING AND PARTICIPANTS:

In total, 227 residents in 20 wards of assisted living facilities in Helsinki were recruited. The 20 wards were randomized into those in which (1) staff received two 4-hour training sessions on appropriate medication treatment (intervention group), and (2) staff received no additional training and continued to provide routine care (control group).

INTERVENTION:

Two 4-hour interactive training sessions for nursing staff based on constructive learning theory to recognize potentially harmful medications and corresponding adverse drug events.

MEASUREMENTS:

Use of potentially harmful medications, HRQoL assessed using the 15 dimensional instrument of health-related quality of life, health service utilization, and mortality assessed at baseline, and 6 and 12 months.

RESULTS:

During the 12-month follow-up, the mean number of potentially harmful medications decreased in the intervention wards [-0.43, 95% confidence interval (CI) -0.71 to -0.15] but remained constant in the control wards (+0.11, 95% CI -0.09 to +0.31) (P = .004, adjusted for age, sex, and comorbidities). HRQoL declined more slowly in the intervention wards (-0.038 (95% CI -0.054 to -0.022) than in the control wards (-0.072 (95% CI -0.089 to -0.055) (P = .005, adjusted for age, sex, and comorbidities). Residents of the intervention wards had significantly less hospital days (1.4 days/person/year, 95% CI 1.2-1.6) than in the control wards (2.3 days/person/year; 95% CI 2.1-2.7) (relative risk 0.60, 95% CI 0.49-0.75, P < .001, adjusted for age, sex, and comorbidities).

CONCLUSIONS:

Activating learning methods directed at nurses in charge of comprehensive care can reduce the use of harmful medications, maintain HRQoL, and reduce hospitalization in residents of assisted living facilities.

Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Inappropriate drugs; anticholinergic drugs; assisted living; polypharmacy; psychotropic drugs; randomized controlled trial

PMID:
24814043
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk