Document Detail


Effects of medication assessment as part of a comprehensive geriatric assessment on drug use over a 1-year period: a population-based intervention study.
MedLine Citation:
PMID:  20524710     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High drug consumption among the elderly and inappropriate prescribing practices increase the risk of adverse drug effects in this population. This risk may be decreased by conducting, for example, a medication review alone or as part of a comprehensive geriatric assessment (CGA); however, little is known about the fate of the changes in medication made as a result of the CGA or medication review. To study the performance of the CGA with regards to medication changes and to determine the persistence of these changes over a 1-year period. This study was a population-based intervention study. A random sample of 1000 elderly (age > or =75 years) was randomized either to a CGA group or to a control group. Home-dwelling patients from these groups (n = 331 and n = 313 for intervention and control groups, respectively) were analysed in this study. Study nurses collected information on medication at study entry and 1 year later in both groups; in the intervention group, study physicians assessed, and changed when appropriate, the medication at study entry. The medication changes and their persistence over 1 year were then evaluated. Medication changes were more frequent in the intervention group than in the control group. Regular medication was changed during follow-up in 277 (83.7%) and in 228 (72.8%) [odds ratio (OR) 1.9; 95% CI 1.3, 2.8] patients in the intervention and control groups, respectively. In the intervention group, study physicians were responsible for 35.4% of all new prescriptions and for 15.6% of all drug terminations. Changes took place particularly in the prescription of CNS drugs. About 58% of the drugs initiated by study physicians were still in use 1 year later, and 25.5% of those terminated by study physicians had been reintroduced. Drug intervention as part of a CGA can be used to rationalize the drug therapy of a patient. However, its effectiveness is subsequently partly counteracted by other physicians working in the healthcare system.
Authors:
Pasi Lampela; Sirpa Hartikainen; Piia Lavikainen; Raimo Sulkava; Risto Huupponen
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Drugs & aging     Volume:  27     ISSN:  1170-229X     ISO Abbreviation:  Drugs Aging     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-07     Completed Date:  2010-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102074     Medline TA:  Drugs Aging     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  507-21     Citation Subset:  IM    
Affiliation:
Department of Pharmacology and Toxicology, University of Kuopio, Kuopio, Finland. Pasi.Lampela@uku.fi
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Drug Interactions
Drug Prescriptions
Drug Therapy*
Drug Toxicity
Drug Utilization Review / methods*
Finland
Geriatric Assessment / methods*
Humans
Intervention Studies
Interviews as Topic
Medical Records
Outpatients
Polypharmacy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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