An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician...

Area of Science:

• Geriatric Medicine
• Pharmacology
• Medical Education

Background:

• Potentially inappropriate medications (PIMs) pose risks for older adults.
• Physician residents require targeted education on geriatric prescribing.
• Academic detailing is a recognized educational intervention.

Purpose of the Study:

• To assess the impact of physician-pharmacist academic detailing on resident confidence in prescribing for older adults.
• To evaluate the effect of this intervention on PIM rates in an emergency department (ED) population.

Main Methods:

• A quality improvement project involving physician residents in a Veteran Affairs ED.
• Pre- and post-intervention surveys assessed knowledge, barriers, and confidence regarding geriatric prescribing.
• Comparison of PIM rates between residents who received academic detailing and a control group.

Main Results:

• Approximately 50% of residents were unfamiliar with Beers Criteria at baseline.
• Intervention significantly improved residents' confidence in identifying drug-disease interactions and prescribing appropriately for older adults.
• Residents receiving academic detailing were significantly less likely to prescribe PIMs (rate ratio 0.73, P < .0001).

Conclusions:

• Academic detailing by a physician-pharmacist team enhances resident prescribing confidence for older adults.
• This intervention is associated with a significant reduction in PIMs prescribed to elderly patients in the ED.