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J Am Geriatr Soc. 2016 Dec;64(12):2487-2494. doi: 10.1111/jgs.14322. Epub 2016 Sep 2.

Knowledge Translation Strategy to Reduce the Use of Potentially Inappropriate Medications in Hospitalized Elderly Adults.

Author information

1
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
2
Research Centre on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
3
Department of Pharmacy, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
4
Department of Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
5
Research Center, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
6
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
7
Programs for Assessment of Technology in Health, Research Institute of St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
8
Faculty of Pharmacy, Université de Montréal, Montréal, Quebec, Canada.
9
Department of Pharmacy, McGill University Health Centre, Montréal, Québec, Canada.
10
Direction of Nursing, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.

Abstract

OBJECTIVES:

To evaluate the effect of a knowledge translation (KT) strategy to reduce potentially inappropriate medication (PIM) use in hospitalized elderly adults.

DESIGN:

Segmented regression analysis of an interrupted time series.

SETTING:

Teaching hospital.

PARTICIPANTS:

Individuals aged 75 and older discharged from the hospital in 2013/14 (mean age 83.3, 54.5% female).

INTERVENTION:

The KT strategy comprises the distribution of educational materials, presentations by geriatricians, pharmacist-physician interventions based on alerts from a computerized alert system, and comprehensive geriatric assessments.

MEASUREMENTS:

Rate of PIM use (number of patient-days with use of at least one PIM/number of patient-days of hospitalization for individuals aged ≥75).

RESULTS:

For 8,622 patients with 14,071 admissions, a total of 145,061 patient-days were analyzed. One or more PIMs were prescribed on 28,776 (19.8%) patient-days; a higher rate was found for individuals aged 75 to 84 (24.0%) than for those aged 85 and older (14.4%) (P < .001), and in women (20.8%) than in men (18.6%) (P < .001). The drug classes most frequently accounting for the PIM were gastrointestinal agents (21%), antihistamines (18%), and antidepressants (17%). An absolute decrease of 3.5% (P < .001) of patient-days with at least one PIM was observed immediately after the intervention.

CONCLUSION:

A KT strategy resulted in decreased use of PIM in elderly adults in the hospital. Additional interventions will be implemented to maintain or further reduce PIM use.

KEYWORDS:

aged; elderly; hospital; knowledge translation; potentially inappropriate medications

PMID:
27590168
DOI:
10.1111/jgs.14322
[Indexed for MEDLINE]

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