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A randomized study to decrease the use of potentially inappropriate medications among community-dwelling older adults
Donna M Fick1, J Ross Maclean, Nancy A Rodriguez
1Department of Medicine and Center for Healthcare Improvement, Medical College of Georgia, Atlanta, Ga, USA. dmf21@mail.psu.edu
The American Journal of Managed Care
|December 30, 2004
Summary
This study tested an intervention to reduce potentially inappropriate medication (PIM) use in older adults. A low-cost method successfully prompted physicians to review and adjust PIM prescriptions, improving geriatric pharmacotherapy.
Area of Science:
- Geriatric pharmacotherapy
- Clinical intervention studies
- Physician prescribing behavior
Background:
- Potentially inappropriate medication (PIM) use in older adults remains a concern.
- Prospective studies demonstrating the effectiveness of interventions targeting PIM use are limited.
Purpose of the Study:
- To design and implement an intervention study focused on altering physician prescribing habits concerning PIMs for elderly patients.
- To assess the impact of a specific intervention on physician behavior regarding PIM prescribing.
Main Methods:
- A prospective randomized block design study was conducted over 18 months.
- The study involved 355 primary care physicians and their patients aged 65+ within a managed care organization.
- Physicians were randomized into an intervention group or a usual-care control group.
Main Results:
- Over 70% of physicians in the intervention group who prescribed PIMs returned at least one completed form.
- Physicians made modifications to PIM use on approximately 15.4% of the submitted medication forms.
Conclusions:
- Intervention studies influencing physician prescribing for older adults are scarce.
- This research presents a cost-effective and reproducible strategy for physician education on geriatric drug therapy issues.