| Effects of medication assessment as part of a comprehensive geriatric assessment on drug use over a 1-year period: a population-based intervention study. | |
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MedLine Citation:
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PMID: 20524710 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Pasi Lampela; Sirpa Hartikainen; Piia Lavikainen; Raimo Sulkava; Risto Huupponen |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Drugs & aging Volume: 27 ISSN: 1170-229X ISO Abbreviation: Drugs Aging Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-07 Completed Date: 2010-08-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102074 Medline TA: Drugs Aging Country: New Zealand |
Other Details:
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Languages: eng Pagination: 507-21 Citation Subset: IM |
Affiliation:
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Department of Pharmacology and Toxicology, University of Kuopio, Kuopio, Finland. Pasi.Lampela@uku.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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