Effect of a geriatric intervention aiming to improve polypharmacy in nursing homes

Abstract

Purpose: To examine the effect of an intervention comprising professional support by a geriatrician engaged in a quality care indicators' audit for nursing home (NH) staff on reducing polypharmacy.

Methods: Of a total of 3709 NH residents, 90 NHs (2026 residents) were allocated to a light intervention and 85 NHs (1683 residents) to a strong intervention group.

Results: Mixed-effect linear model found no significant variation in the total number of medications over time (β-coefficient for interaction 0.007, 95% CI - 0.15, 0.16). Within-group-adjusted mean differences showed a statistical decline in the psychotropic medication class (- 0.04 SE 0.02 p 0.03 for the strong intervention group and - 0.06 SE 0.02 p 0.001 for the light intervention group) and a statistically significant increase in the analgesics use.

Conclusion: The possibility that a simple audit intervention might reduce psychotropic prescriptions deserves further investigation.

Keywords: Global intervention; IQUARE; Individualized prescription adaptation (IPA); Nursing home; Polypharmacy.