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Risk Indicators Improve the Prescription Quality of Drugs with Anticholinergic Properties in Nursing Homes

Aim: The objective of this study was to assess the impact of a collaborative therapeutic optimization program on the rate of potentially inappropriate prescription of drugs with anticholinergic properties in nursing homes. Methods: Quasi-experimental study in 37 nursing homes in France. The interven...

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Autores principales: Sanchez, Stéphane, Chrusciel, Jan, Ndiongue, Biné Mariam, Blochet, Caroline, Forget, Jean François, Letty, Aude, Hay, Paul Emile, Novella, Jean Luc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744764/
https://www.ncbi.nlm.nih.gov/pubmed/35010682
http://dx.doi.org/10.3390/ijerph19010423
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author Sanchez, Stéphane
Chrusciel, Jan
Ndiongue, Biné Mariam
Blochet, Caroline
Forget, Jean François
Letty, Aude
Hay, Paul Emile
Novella, Jean Luc
author_facet Sanchez, Stéphane
Chrusciel, Jan
Ndiongue, Biné Mariam
Blochet, Caroline
Forget, Jean François
Letty, Aude
Hay, Paul Emile
Novella, Jean Luc
author_sort Sanchez, Stéphane
collection PubMed
description Aim: The objective of this study was to assess the impact of a collaborative therapeutic optimization program on the rate of potentially inappropriate prescription of drugs with anticholinergic properties in nursing homes. Methods: Quasi-experimental study in 37 nursing homes in France. The intervention included the use of quality indicators for prescriptions combined with educational sessions and dedicated materials for nursing home staff (unlimited access to study material for staff, including nurses, general practitioners, pharmacists). Indicators were calculated based on routine data collected from an electronic pill dispenser system. The primary outcome was the presence of at least one prescription containing ≥1 drug from a list of 12 drugs with anticholinergic properties. A difference-in-differences analysis was conducted at 18 months as well as propensity score weighting to minimize any potential indication bias. A generalized estimating equation model estimated the probability of being prescribed at least one target drug at any time during a 9-month period for each resident. Results: In total, 33 nursing homes (intervention group: n = 10; control group: n = 23) were included, totalling 8137 residents. There was a decrease in the use of drugs with anticholinergic properties over time in both groups, as well as a decline in the intervention group compared to the control group (Odds Ratio: 0.685, 95% CI: 0.533, 0.880; p < 0.01) that was attributable to the intervention. An estimated 49 anticholinergic properties drug prescriptions were avoided by the intervention. Conclusion: This study found that an intervention based on indicators derived from routine prescription data was effective in reducing use of drugs with anticholinergic properties prescriptions in nursing homes.
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spelling pubmed-87447642022-01-11 Risk Indicators Improve the Prescription Quality of Drugs with Anticholinergic Properties in Nursing Homes Sanchez, Stéphane Chrusciel, Jan Ndiongue, Biné Mariam Blochet, Caroline Forget, Jean François Letty, Aude Hay, Paul Emile Novella, Jean Luc Int J Environ Res Public Health Article Aim: The objective of this study was to assess the impact of a collaborative therapeutic optimization program on the rate of potentially inappropriate prescription of drugs with anticholinergic properties in nursing homes. Methods: Quasi-experimental study in 37 nursing homes in France. The intervention included the use of quality indicators for prescriptions combined with educational sessions and dedicated materials for nursing home staff (unlimited access to study material for staff, including nurses, general practitioners, pharmacists). Indicators were calculated based on routine data collected from an electronic pill dispenser system. The primary outcome was the presence of at least one prescription containing ≥1 drug from a list of 12 drugs with anticholinergic properties. A difference-in-differences analysis was conducted at 18 months as well as propensity score weighting to minimize any potential indication bias. A generalized estimating equation model estimated the probability of being prescribed at least one target drug at any time during a 9-month period for each resident. Results: In total, 33 nursing homes (intervention group: n = 10; control group: n = 23) were included, totalling 8137 residents. There was a decrease in the use of drugs with anticholinergic properties over time in both groups, as well as a decline in the intervention group compared to the control group (Odds Ratio: 0.685, 95% CI: 0.533, 0.880; p < 0.01) that was attributable to the intervention. An estimated 49 anticholinergic properties drug prescriptions were avoided by the intervention. Conclusion: This study found that an intervention based on indicators derived from routine prescription data was effective in reducing use of drugs with anticholinergic properties prescriptions in nursing homes. MDPI 2021-12-31 /pmc/articles/PMC8744764/ /pubmed/35010682 http://dx.doi.org/10.3390/ijerph19010423 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sanchez, Stéphane
Chrusciel, Jan
Ndiongue, Biné Mariam
Blochet, Caroline
Forget, Jean François
Letty, Aude
Hay, Paul Emile
Novella, Jean Luc
Risk Indicators Improve the Prescription Quality of Drugs with Anticholinergic Properties in Nursing Homes
title Risk Indicators Improve the Prescription Quality of Drugs with Anticholinergic Properties in Nursing Homes
title_full Risk Indicators Improve the Prescription Quality of Drugs with Anticholinergic Properties in Nursing Homes
title_fullStr Risk Indicators Improve the Prescription Quality of Drugs with Anticholinergic Properties in Nursing Homes
title_full_unstemmed Risk Indicators Improve the Prescription Quality of Drugs with Anticholinergic Properties in Nursing Homes
title_short Risk Indicators Improve the Prescription Quality of Drugs with Anticholinergic Properties in Nursing Homes
title_sort risk indicators improve the prescription quality of drugs with anticholinergic properties in nursing homes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744764/
https://www.ncbi.nlm.nih.gov/pubmed/35010682
http://dx.doi.org/10.3390/ijerph19010423
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