Safer Prescribing and Care for the Elderly (SPACE): a pilot study in general practice

Area of Science:

• Geriatric Medicine
• Pharmacology
• Primary Care

Background:

• High-risk prescribing increases patient risk of adverse drug events (ADEs), particularly in older adults with multiple chronic conditions.
• The Safer Prescribing and Care for the Elderly (SPACE) intervention aims to improve medicines management and medication review.
• Increasing polypharmacy in aging populations necessitates strategies to mitigate ADEs.

Purpose of the Study:

• To pilot the SPACE intervention in primary care settings.
• To evaluate the feasibility of the SPACE intervention before a larger cluster randomized controlled trial (RCT).

Main Methods:

• A pilot study conducted in two general practices.
• Inclusion of patients at high risk for ADEs from non-steroidal anti-inflammatory drugs (NSAIDs) and/or antiplatelet medications.
• Primary outcome measured was the proportion of patients with high-risk prescribing at 6 and 12 months, compared to baseline.

Main Results:

• The SPACE intervention was successfully delivered within existing primary care infrastructure.
• A reduction in high-risk prescribing was observed at 6 months post-intervention.
• The observed improvements in prescribing safety were not sustained at the 12-month follow-up.

Conclusions:

• The SPACE intervention shows short-term promise in prompting medication review and enhancing safer prescribing practices in general practice.
• The findings support the initiation of a larger randomized trial to further investigate the SPACE intervention's efficacy.
• Long-term effectiveness of the SPACE intervention requires further evaluation in a larger cohort.