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The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study

Background: Potentially inappropriate prescribing (PIP) is associated with the incidence of adverse drug reactions, drug-related hospitalization and other negative outcomes in older adults. After hospitalization, older adults might be discharged with several types of PIPs. Studies have found that th...

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Main Authors: Akkawi, Muhammad Eid, Nik Mohamed, Mohamad Haniki, Md Aris, Mohd Aznan
Format: Article
Language:English
English
Published: BioMed Central 2020
Subjects:
R Medicine (General)
RA Public aspects of medicine
RS Pharmacy and materia medica
Online Access:http://irep.iium.edu.my/82413/1/s40545-020-00236-0%20%281%29.pdf
http://irep.iium.edu.my/82413/7/Scopus%20-%20Document%20details.pdf
http://irep.iium.edu.my/82413/
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spelling my.iium.irep.824132020-08-27T08:45:39Z http://irep.iium.edu.my/82413/ The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study Akkawi, Muhammad Eid Nik Mohamed, Mohamad Haniki Md Aris, Mohd Aznan R Medicine (General) RA Public aspects of medicine RS Pharmacy and materia medica Background: Potentially inappropriate prescribing (PIP) is associated with the incidence of adverse drug reactions, drug-related hospitalization and other negative outcomes in older adults. After hospitalization, older adults might be discharged with several types of PIPs. Studies have found that the lack of healthcare professionals’ (HCPs) knowledge regarding PIP is one of the major contributing factors in this issue. The purpose of this study is to investigate the impact of a multifaceted intervention on physicians’ and clinical pharmacists’ behavior regarding potentially inappropriate medication (PIM) and potential prescribing omission (PPO) among hospitalized older adults. Methods: This is a before-and-after study that took place in a tertiary Malaysian hospital. Discharge medications of patients ≥65years old were reviewed to identify PIMs/PPOs using version 2 of the STOPP/START criteria. The prevalence and pattern of PIM/PPO before and after the intervention were compared. The intervention targeted the physicians and clinical pharmacists and it consisted of academic detailing and a newly developed smartphone application (app). Results: The study involved 240 patients before (control group) and 240 patients after the intervention. The prevalence of PIM was 22% and 27% before and after the intervention, respectively (P=0.213). The prevalence of PPO in the intervention group was significantly lower than that in the control group (42% Vs. 53.3%); P=0.014. This difference remained statistically significant after controlling for other variables (P=0.015). The intervention was effective in reducing the two most common PPOs; the omission of vitamin D supplements in patients with a history of falls (P=0.001) and the omission of angiotensin converting enzyme inhibitor in patients with coronary artery disease (P=0.03). Conclusions: The smartphone app coupled with academic detailing was effective in reducing the prevalence of PPO at discharge. However, it did not significantly affect the prevalence or pattern of PIM. Keywords: Potentially inappropriate medication, Potential prescribing omission, Older adults, Academic detailing, Smartphone app BioMed Central 2020-07-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/82413/1/s40545-020-00236-0%20%281%29.pdf application/pdf en http://irep.iium.edu.my/82413/7/Scopus%20-%20Document%20details.pdf Akkawi, Muhammad Eid and Nik Mohamed, Mohamad Haniki and Md Aris, Mohd Aznan (2020) The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study. Journal of Pharmaceutical Policy and Practice, 13 (1). pp. 1-11. ISSN 20523211 10.1186/s40545-020-00236-0
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
English
topic R Medicine (General)
RA Public aspects of medicine
RS Pharmacy and materia medica
spellingShingle R Medicine (General)
RA Public aspects of medicine
RS Pharmacy and materia medica
Akkawi, Muhammad Eid
Nik Mohamed, Mohamad Haniki
Md Aris, Mohd Aznan
The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study
description Background: Potentially inappropriate prescribing (PIP) is associated with the incidence of adverse drug reactions, drug-related hospitalization and other negative outcomes in older adults. After hospitalization, older adults might be discharged with several types of PIPs. Studies have found that the lack of healthcare professionals’ (HCPs) knowledge regarding PIP is one of the major contributing factors in this issue. The purpose of this study is to investigate the impact of a multifaceted intervention on physicians’ and clinical pharmacists’ behavior regarding potentially inappropriate medication (PIM) and potential prescribing omission (PPO) among hospitalized older adults. Methods: This is a before-and-after study that took place in a tertiary Malaysian hospital. Discharge medications of patients ≥65years old were reviewed to identify PIMs/PPOs using version 2 of the STOPP/START criteria. The prevalence and pattern of PIM/PPO before and after the intervention were compared. The intervention targeted the physicians and clinical pharmacists and it consisted of academic detailing and a newly developed smartphone application (app). Results: The study involved 240 patients before (control group) and 240 patients after the intervention. The prevalence of PIM was 22% and 27% before and after the intervention, respectively (P=0.213). The prevalence of PPO in the intervention group was significantly lower than that in the control group (42% Vs. 53.3%); P=0.014. This difference remained statistically significant after controlling for other variables (P=0.015). The intervention was effective in reducing the two most common PPOs; the omission of vitamin D supplements in patients with a history of falls (P=0.001) and the omission of angiotensin converting enzyme inhibitor in patients with coronary artery disease (P=0.03). Conclusions: The smartphone app coupled with academic detailing was effective in reducing the prevalence of PPO at discharge. However, it did not significantly affect the prevalence or pattern of PIM. Keywords: Potentially inappropriate medication, Potential prescribing omission, Older adults, Academic detailing, Smartphone app
format Article
author Akkawi, Muhammad Eid
Nik Mohamed, Mohamad Haniki
Md Aris, Mohd Aznan
author_facet Akkawi, Muhammad Eid
Nik Mohamed, Mohamad Haniki
Md Aris, Mohd Aznan
author_sort Akkawi, Muhammad Eid
title The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study
title_short The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study
title_full The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study
title_fullStr The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study
title_full_unstemmed The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study
title_sort impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study
publisher BioMed Central
publishDate 2020
url http://irep.iium.edu.my/82413/1/s40545-020-00236-0%20%281%29.pdf
http://irep.iium.edu.my/82413/7/Scopus%20-%20Document%20details.pdf
http://irep.iium.edu.my/82413/
_version_ 1677780705779646464
score 13.211869

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