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- Lenander, Cecilia, et al.
(författare)
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Effects of an intervention (SäkläK) on prescription of potentially inappropriate medication in elderly patients
- 2017
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Ingår i: Family Practice. - : Oxford University Press (OUP). - 0263-2136 .- 1460-2229. ; 34:2, s. 213-218
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Tidskriftsartikel (refereegranskat)abstract
- Background. Polypharmacy is known to increase the risk for drug-related problems, and some drugs, potentially inappropriate medications (PIMs), are especially troublesome. Objective. To analyse the effects on prescription of PIMs of the SäKLäK project, an intervention model created to improve medication safety for elderly patients in primary care. Method. The SäkläK project was a multiprofessional intervention in primary care consisting of self-assessment, peer review, feedback and written agreements for change. Five Swedish primary care centres participated in the intervention and five served as comparison group. Data were collected from the Swedish Prescribed Drug Register on PIMs (long-acting benzodiazepines, anticholinergics, tramadol, propiomazine, antipsychotics and non-steroidal anti-inflammatory drugs) prescribed to patients aged 65 years and older. Total number of patients and change in patients using PIMs before and after intervention with-in groups was analysed as well as differences between intervention and comparison group. Results. A total of 32 566 prescriptions of PIMs were dispensed before the intervention, 19 796 in the intervention group and 12 770 in the comparison group. After intervention a decrease was seen in both groups, intervention-22.2% and comparison-8.8%. All groups of PIMs decreased, except for antipsychotics in the comparison group. For the intervention group, a significant decrease in mean dose/patient was seen after the intervention but not in the comparison group. Conclusion. Our study shows this method has some effects on prescription of PIMs. The evaluation indicates this is a feasible method for improvement of medication use in primary care and the method should be tested on a larger scale.
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| 3. |
- Lenander, Cecilia, et al.
(författare)
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Use of Antipsychotic Drugs by Elderly Primary Care Patients and the Effects of Medication Reviews: A Cross-Sectional Study in Sweden
- 2017
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Ingår i: Drugs - Real World Outcomes. - : Springer Science and Business Media LLC. - 2199-1154 .- 2198-9788. ; 4:3, s. 159-165
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Tidskriftsartikel (refereegranskat)abstract
- Background Antipsychotics form a class of drugs that should be used with caution among elderly people because of a high risk of adverse events. Despite the risks and modest effects, their use is estimated to be high, especially in nursing homes. Objective The aim was to explore the effects of medication reviews on antipsychotic drug use for elderly primary care patients and describe the extent of, and reasons for, the prescription of antipsychotics.Methods In this cross-sectional study in primary care in Skane, Sweden, patients aged >75 years living in nursing homes or in their own homes with home care were included. The effects of medication reviews were documented, as were the use of antipsychotics and the differences in characteristics between patients receiving or not receiving antipsychotics.Results A total of 1683 patients aged 87.6 (±5.7) years were included in the analysis. Medication reviews reduced the use of antipsychotics by 23% (p\0.001) in this study. Of the 206 patients using antipsychotics, 43% (n = 93) had an approved indication, while for 15% (n = 32) the indication was not given. Antipsychotic drug use was more common with increasing number of drugs (p = 0.001), and in nursing home residents (p\0.01). It was also morefrequent in patients with cognitive impairment, depressive symptoms or sleeping problems.Conclusion The use of antipsychotic drugs is high in elderly patients in nursing homes. They are often given for indications that are not officially approved or are poorly documented. Medication reviews appear to offer one usefulstrategy for reducing excessive use of these drugs.
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