2011 年至 2014 年期间，处方手册对疗养院居民药物使用量无影响：一项对照前后研究。
No impact of a prescription booklet on medication consumption in nursing home residents from 2011 to 2014: a controlled before-after study.
机构信息
Fondation Korian Pour le Bien Vieillir, 25 Rue Balzac, 75008, Paris, France.
Centre Hospitalier de Troyes, Pôle Information Médicale Évaluation Performance, 101 Av Anatole France, 10000, Troyes, France.
出版信息
Aging Clin Exp Res. 2021 Jun;33(6):1599-1607. doi: 10.1007/s40520-020-01670-5. Epub 2020 Aug 3.
BACKGROUND
Older persons are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. We aimed to evaluate the impact on medication consumption, of a booklet designed to aid physicians with prescriptions for elderly nursing home residents.
METHODS
Among 519 nursing homes using an electronic pill dispenser, we recorded the daily number of times that a drug was administered for each resident, over a period of 4 years. The intervention group comprised 113 nursing homes belonging to a for-profit geriatric care provider that implemented a booklet delivered to prescribers and pharmacists and specifically designed to aid with prescriptions for elderly nursing home residents. The remaining 406 nursing homes where no such booklet was introduced comprised the control group. Data were derived from electronic pill dispensers. The effect of the intervention on medication consumption was assessed with multilevel regression models, adjusted for nursing home status. The main outcomes were the average daily number of times that a medication was administered and the number of drugs with different presentation identifier codes per resident per month.
RESULTS
96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (- 0.05 and - 0.06). The booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P = .45).
CONCLUSION
We observed an overall decrease in medication consumption in both the control and intervention groups. Our analysis did not provide any evidence that this reduction was related to the use of the booklet. Other factors, such as national policy or increased physician awareness, may have contributed to our findings.
背景
老年人特别容易受到药物不良反应的影响。在减少多种用药的各种策略中，教育方法已显示出良好的效果。我们旨在评估一种旨在帮助医生为老年疗养院居民开处方的小册子对药物使用的影响。
方法
在使用电子药丸分配器的 519 家疗养院中，我们记录了每位居民在 4 年内每天给药的次数。干预组由属于营利性老年护理提供商的 113 家疗养院组成，该提供商实施了一种小册子，分发给处方医生和药剂师，专门用于帮助为老年疗养院居民开处方。其余 406 家未引入此类小册子的疗养院为对照组。数据来自电子药丸分配器。使用多层次回归模型评估干预对药物消耗的影响，调整疗养院状况。主要结果是每位居民每月每种药物的平均每日给药次数和不同剂型标识符代码的药物数量。
结果
2011 年 1 月 1 日至 2014 年 12 月 31 日期间，519 家疗养院的 96216 名居民入组。干预组和对照组的平均每日用药量均减少（-0.05 和-0.06）。小册子的效果没有统计学意义（差异差异系数的指数化差 1.00，95%置信区间 0.99-1.02，P=0.45）。
结论
我们观察到对照组和干预组的药物使用量均总体减少。我们的分析没有提供任何证据表明这种减少与小册子的使用有关。其他因素，如国家政策或医生意识的提高，可能促成了我们的发现。
Zotero 插件