Impact of educational intervention on prescribing inappropriate medication to elderly nursing homes residents.

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.