Knowledge Translation Strategy to Reduce the Use of Potentially Inappropriate Medications in Hospitalized Elderly Adults
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ObjectivesTo evaluate the effect of a knowledge translation (KT) strategy to reduce potentially inappropriate medication (PIM) use in hospitalized elderly adults.DesignSegmented regression analysis of an interrupted time series.SettingTeaching hospital.ParticipantsIndividuals aged 75 and older discharged from the hospital in 2013/14 (mean age 83.3, 54.5% female).InterventionThe KT strategy comprises the distribution of educational materials, presentations by geriatricians, pharmacist–physician interventions based on alerts from a computerized alert system, and comprehensive geriatric assessments.MeasurementsRate of PIM use (number of patient‐days with use of at least one PIM/number of patient‐days of hospitalization for individuals aged ≥75).ResultsFor 8,622 patients with 14,071 admissions, a total of 145,061 patient‐days were analyzed. One or more PIMs were prescribed on 28,776 (19.8%) patient‐days; a higher rate was found for individuals aged 75 to 84 (24.0%) than for those aged 85 and older (14.4%) (P < .001), and in women (20.8%) than in men (18.6%) (P < .001). The drug classes most frequently accounting for the PIM were gastrointestinal agents (21%), antihistamines (18%), and antidepressants (17%). An absolute decrease of 3.5% (P < .001) of patient‐days with at least one PIM was observed immediately after the intervention.ConclusionA KT strategy resulted in decreased use of PIM in elderly adults in the hospital. Additional interventions will be implemented to maintain or further reduce PIM use.
