Educating Doctors About Prescription Risks

A study finds that teaching doctors about potentially inappropriate medications for seniors may be more effective than targeting patients with similar information.

The effort among Italian doctors resulted in a significant decline in the prescription of such drugs in a three-year period.

Prescribing potentially inappropriate medications for those aged 65 and older dropped from 7.8% to 5.3% after physicians received information about appropriately treating older patients. The results of the study are published in an issue of the journal Drugs & Aging.

In the control group, the reduction was notable, but not of the same significance — from 7.7% down to 6.1% after three years — according to lead author Scott Keith, PhD of Thomas Jefferson University in Philadelphia.

The study involved approximately 80,000 patients, and the results reflect that 608 of those patients were not exposed to medications that may have been inappropriate during the final leg of the study. While the study authors do not believe that such prescriptions will disappear entirely, the intervention shows that educating physicians about the risks attached to the medications may be an effective strategy.

The researchers identified potentially inappropriate medications as those that held risks that may outweigh the expected benefits when considering alternative treatment options. Because about one-third of all prescription drugs in the United States are for patients aged 65 and older, the strategy could make a major impact in reducing the number of medication-related problems.

The list of potentially inappropriate medications was developed by the researchers according to the Beers Criteria from the American Geriatrics Society. Through examination, they eventually identified 23 medications, including atypical antipsychotics and non-steroidal anti-inflammatories.

The researchers chose to conduct their research in Italy because the universal health coverage system would provide a simpler setting than some other nations’ programs. The program issued several educational strategies to 303 general practitioners in Parma, Italy.

Included in the intervention was a list of medications to be avoided, in combination with a list of alternative options, as well as annual reviews of incidences involving targeted medications and educational sessions including case-study reviews.

The researchers discovered that when seniors were advised to use potentially inappropriate medications, they had a shorter time period before a hospitalization occurred, had more hospitalization instances and experienced more adverse reactions.

The authors believe that one positive note of the interventions is that they did not place an unreasonable burden on the physicians, and the intervention can be easily duplicated to other settings.

The results indicate that there may be value in providing physicians, rather than patients, with information about potentially inappropriate medication. This is true particularly for older adults, who make up a significant portion of the prescriptions issued.

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