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Randomized Controlled Trial
. 2016 Jul;82(1):53-63.
doi: 10.1111/bcp.12922. Epub 2016 Apr 5.

E-learning in order to improve drug prescription for hospitalized older patients: a cluster-randomized controlled study

Carlotta Franchi  1 , Mauro Tettamanti  1 , Codjo Dgnefa Djade  1 , Luca Pasina  1 , Pier Mannuccio Mannucci  2 , Graziano Onder  3 , Gualberto Gussoni  4 , Dario Manfellotto  5 , Stefano Bonassi  6 , Francesco Salerno  7 , Alessandro Nobili  1 ; ELICADHE Investigators
Affiliations
Randomized Controlled Trial

E-learning in order to improve drug prescription for hospitalized older patients: a cluster-randomized controlled study

Carlotta Franchi et al. Br J Clin Pharmacol. 2016 Jul.

Abstract

Aims: The aim of the study was to evaluate the effect of an e-learning educational program meant to foster the quality of drug prescription in hospitalized elderly patients.

Methods: Twenty geriatric and internal medicine wards were randomized to intervention (e-learning educational program) or control (basic geriatric pharmacology notions). Logistic regression analysis was used in order to assess the effect of the intervention on the use of potentially inappropriate medication (PIM, primary outcome) at hospital discharge. Secondary outcomes were a reduced prevalence of at least one potential drug-drug interaction (DDI) and potentially severe DDI at discharge. Mortality rate and incidence of re-hospitalizations were other secondary outcomes assessed at the 12-month follow-up.

Results: A total of 697 patients (347 in the intervention and 350 in the control arms) were enrolled. No difference in the prevalence of PIM at discharge was found between arms (OR 1.29 95%CI 0.87-1.91). We also found no decrease in the prevalence of DDI (OR 0.67 95%CI 0.34-1.28) and potentially severe DDI (OR 0.86 95%CI 0.63-1.15) at discharge, nor in mortality rates and incidence of re-hospitalization at 12-month follow-up.

Conclusions: This e-learning educational program had no clear effect on the quality of drug prescription and clinical outcomes in hospitalized elderly patients. Given the high prevalence of PIMs and potential DDIs recorded in the frame of this study, other approaches should be developed in order to improve the quality of drug prescription in this population.

Trial registration: ClinicalTrials.gov NCT02339792.

Keywords: E-learning; comprehensive geriatric assessment; drug prescription; drug-drug interaction; elderly people; potentially inappropriate medication.

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Figures

Figure 1
Figure 1
Study flow chart. CGA: Comprehensive Geriatric Assesment; GPNs: Geriatric pharmacological notions
Figure 2
Figure 2
Secondary outcome results: (A) survival and (B) incident re‐hospitalization rates at 12‐month follow‐up
See this image and copyright information in PMC

References

    1. Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, Meinow B, Fratiglioni L. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011; 10: 430–9. - PubMed
    1. Mannucci PM, Nobili A, REPOSI Investigators . Multimorbidity and polypharmacy in the elderly: lessons from REPOSI. Intern Emerg Med 2014; 9: 723–34. - PubMed
    1. Onder G, Bonassi S, Abbatecola AM, Folino‐Gallo P, Lapi F, Marchionni N, Pani L, Pecorelli S, Sancarlo D, Scuteri A, Trifirò G, Vitale C, Zuccaro SM, Bernabei R, Fini M, Geriatrics Working Group of the Italian Medicines Agency . High prevalence of poor quality drug prescribing in older individuals: a nationwide report from the Italian Medicines Agency (AIFA). J Gerontol A Biol Sci Med Sci 2014; 69: 430–7. - PubMed
    1. Onder G, van der Cammen TJ, Petrovic M, Somers A, Rajkumar C. Strategies to reduce the risk of iatrogenic illness in complex older adults. Age Ageing 2013; 42: 284–91. - PubMed
    1. Klotz U. Pharmacokinetics and drug metabolism in the elderly. Drug Metab Rev 2009; 41: 67–76. - PubMed

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