Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 3-4, Pages: 174-179
https://doi.org/10.2298/SARH1504174I
Full text (
186 KB)
Cited by
Impact of educational intervention on prescribing inappropriate medication to elderly nursing homes residents
Ilić Darko (Army of Serbia, Bureau of Preventive Medical Services, Belgrade)
Bukumirić Zoran 
(School of Medicine, Institute of Medical Statistics and Informatics, Belgrade)
Janković Slobodan (Faculty of Medical Sciences, Kragujevac)
Introduction. Problems with polypharmacy, adverse drug reactions and
non-adherence are especially frequent among elderly nursing home residents.
Objective. The aim of our study was to evaluate effectiveness of a specific
form of staff education on appropriateness of prescribing in a cluster of
nursing homes for the elderly. Methods. The study was designed as
before-and-after trial of educational intervention on appropriateness of
prescribing in nursing homes for the elderly. In total 20 nursing homes
located in Belgrade, Serbia were included in the study with 104 elderly
residents and 27 caring physicians. Appropriateness of prescribing was
checked against Beers, START and STOPP criteria, before and 6 months after
the intervention. Results. There were 349 inappropriately prescribed drugs
according to Beers criteria before the intervention and 37 drugs six months
after the intervention. According to STOPP criteria there were 70 drugs
inappropriately prescribed before the intervention, and 20 drugs 6 months
after. When both criteria are taken together, there is a significant
difference between the average number of inappropriate drugs per patient
before (3.4±0.5) and after (0.6±0.7) educational intervention (t=38.902;
p<0.001). Finally, before the intervention 143 appropriate drugs were omitted
according to START criteria, while 6 months after the intervention there were
only 67 omissions. Conclusion. Simple, but well targeted educational
interventions may improve polypharmacy and decrease inappropriate prescribing
rate, contributing to a better care of elderly patients in nursing homes.
Keywords: elderly, nursing homes, inappropriate prescribing, education, polypharmacy
Projekat Ministarstva nauke Republike Srbije, br. 175007