TY - JOUR
T1 - A Quality Use of Medicines program for general practitioners and older people
T2 - A cluster randomised controlled trial
AU - Pit, Sabrina W.
AU - Byles, Julie E.
AU - Henry, David A.
AU - Holt, Lucy
AU - Hansen, Vibeke
AU - Bowman, Deborah A.
PY - 2007/7/2
Y1 - 2007/7/2
N2 - Objective: To investigate the effectiveness of an educational Quality Use of Medicines program, delivered at the level of general practice, on medicines use, falls and quality of life in people aged ≥ 65 years. Design: Cluster randomised controlled trial conducted in 2002. Setting: General practices in the Hunter Region, New South Wales, Australia. Participants: Twenty general practitioners recruited 849 patients to participate in the study. Intervention: Education (academic detailing, provision of prescribing information and feedback); medication risk assessment; facilitation of medication review; financial incentives. Main outcome measures: Primary measures: a composite score reflecting use of benzodiazepines, non-steroidal anti-inflammatory drugs (NSAIDs) and thiazide diuretics; secondary measures: use of medication reviews, occurrence of falls, quality of life (as assessed by SF-12 and EQ-5D survey scores. Results: Compared with the control group, participants in the intervention group had increased odds of having an improved medication use composite score (odds ratio [OR], 1.86; 95% Cl, 1.21-2.85) at 4-month follow-up but not at 12 months. At 4-month follow-up, the intervention group had reduced odds of using NSAIDs (OR, 0.62; 95% Cl, 0.39-0.99) and showed a non-significant reduction in use of benzodiazepines (OR, 0.51; 95% Cl, 0.20-1.30) and thiazide diuretics (OR, 0.70; 95% Cl, 0.48-1.01). Changes in drug use were not significant at 12-month follow-up. At 12 months, intervention-group participants had lower adjusted ORs (AORs) for having a fall (AOR, 0.61; 95% Cl, 0.41-0.91), injury (AOR, 0.56; 95% Cl, 0.32-0.96), and injury requiring medical attention (AOR, 0.46; 95% Cl, 0.30-0.70). Quality-of-life scores were unaffected by the intervention. Conclusion: Education and systems for medication review conducted by GPs can be used to improve use of medicines. These interventions are associated with a reduction in falls among older people, without adverse effects on quality of life.
AB - Objective: To investigate the effectiveness of an educational Quality Use of Medicines program, delivered at the level of general practice, on medicines use, falls and quality of life in people aged ≥ 65 years. Design: Cluster randomised controlled trial conducted in 2002. Setting: General practices in the Hunter Region, New South Wales, Australia. Participants: Twenty general practitioners recruited 849 patients to participate in the study. Intervention: Education (academic detailing, provision of prescribing information and feedback); medication risk assessment; facilitation of medication review; financial incentives. Main outcome measures: Primary measures: a composite score reflecting use of benzodiazepines, non-steroidal anti-inflammatory drugs (NSAIDs) and thiazide diuretics; secondary measures: use of medication reviews, occurrence of falls, quality of life (as assessed by SF-12 and EQ-5D survey scores. Results: Compared with the control group, participants in the intervention group had increased odds of having an improved medication use composite score (odds ratio [OR], 1.86; 95% Cl, 1.21-2.85) at 4-month follow-up but not at 12 months. At 4-month follow-up, the intervention group had reduced odds of using NSAIDs (OR, 0.62; 95% Cl, 0.39-0.99) and showed a non-significant reduction in use of benzodiazepines (OR, 0.51; 95% Cl, 0.20-1.30) and thiazide diuretics (OR, 0.70; 95% Cl, 0.48-1.01). Changes in drug use were not significant at 12-month follow-up. At 12 months, intervention-group participants had lower adjusted ORs (AORs) for having a fall (AOR, 0.61; 95% Cl, 0.41-0.91), injury (AOR, 0.56; 95% Cl, 0.32-0.96), and injury requiring medical attention (AOR, 0.46; 95% Cl, 0.30-0.70). Quality-of-life scores were unaffected by the intervention. Conclusion: Education and systems for medication review conducted by GPs can be used to improve use of medicines. These interventions are associated with a reduction in falls among older people, without adverse effects on quality of life.
UR - http://www.scopus.com/inward/record.url?scp=34447503265&partnerID=8YFLogxK
M3 - Article
C2 - 17605699
AN - SCOPUS:34447503265
SN - 0025-729X
VL - 187
SP - 23
EP - 30
JO - Medical Journal of Australia
JF - Medical Journal of Australia
IS - 1
ER -