Intervention Cuts Potentially Inappropriate Medications in Seniors

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An intervention OPTI-SCRIPT can reduce PIP in older patients.
An intervention OPTI-SCRIPT can reduce PIP in older patients.

HealthDay News -- An intervention (Optimizing Prescribing for Older People in Primary Care [OPTI-SCRIPT]) can reduce potentially inappropriate prescribing (PIP) in older patients, according to a study published in the Annals of Family Medicine.

Barbara Clyne, PhD, from the Royal College of Surgeons in Dublin, and colleagues conducted a cluster-randomized controlled trial among 21 general practitioner practices and 190 patients with PIP. Participants in intervention practices received a complex, multifaceted intervention, including academic detailing; review of medicines, with web-based pharmaceutical treatment algorithms providing alternative treatment options; and tailored information leaflets. Control practices delivered usual care and received PIP feedback at the patient level.

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The researchers found that patients in the intervention group had significantly lower odds of having PIP than patients in the control group at intervention completion (adjusted odds ratio, 0.32; P = 0.02). The mean number of PIP drugs was 0.70 and 1.18 in the intervention and control groups, respectively (P = 0.02). At intervention completion, the intervention group was less likely to have PIP drugs than the control group, but the difference was not significant (incidence rate ratio, 0.71; 95% confidence interval, 0.50 to 1.02; P = 0.49). The intervention effectively reduced proton pump inhibitor prescribing (adjusted odds ratio, 0.30; P = 0.04).

"The OPTI-SCRIPT intervention incorporating academic detailing with a pharmacist, and a review of medicines with web-based pharmaceutical treatment algorithms, was effective in reducing PIP," the authors wrote.

Reference

Clyne B, Smith S, Hughes C et al. Effectiveness of a Multifaceted Intervention for Potentially Inappropriate Prescribing in Older Patients in Primary Care: A Cluster-Randomized Controlled Trial (OPTI-SCRIPT Study). Ann Fam Med. 2015;13(6):545-553. doi:10.1370/afm.1838.

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