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Randomized Controlled Trial
. 2023 Oct;35(10):2227-2235.
doi: 10.1007/s40520-023-02513-9. Epub 2023 Aug 7.

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study

Regina Stolz  1 , Olaf Krause  2 , Ulrike Junius-Walker  2 , Petra Thürmann  3 , Angela Fuchs  4 , Stefan Wilm  4 , Anja Wollny  5 , Franziska Rebentisch  5 , Birgitt Wiese  2 , Stefanie Joos  6 , Hannah Haumann  6
Affiliations
Randomized Controlled Trial

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study

Regina Stolz et al. Aging Clin Exp Res. 2023 Oct.

Abstract

Background: Nursing home residents (NHR) show high rates of polypharmacy. The HIOPP-3-iTBX study is the first cRCT on medication optimization in nursing homes (NH) in Germany. The intervention did not result in a reduction of PIM and/or antipsychotics. This analysis looks at structure quality in the HIOPP-3-iTBX study participants.

Aims: Evaluation of structure quality as part of a cluster-randomized controlled intervention study.

Methods: Structure quality in multiprofessional teams from n = 44 NH (n = 44 NH directors, n = 91 family doctors (FD), and n = 52 pharmacies with n = 62 pharmacists) was assessed using self-designed questionnaires at baseline. Main aspects of the questionnaires related to the qualification of participants, quality management, the medication process and size of the facilities. All completed questionnaires were included. number of PIM/antipsychotics was drawn from the baseline medication analysis in 692 NHR. Data were analyzed by descriptive statistics and mixed model logistic regression.

Results: The presence of a nurse with one of the additional qualifications pain nurse or Zertifiziertes Curriculum (Zercur) Geriatrie in the participating NH was associated with a lower risk for the prescription of PIM/antipsychotics. No association between any characteristic in the other participants at baseline was observed.

Conclusions and discussion: The results support the known role of nursing qualification in the quality and safety of care. Further studies need to look more closely at how use is made of the additional qualifications within the multiprofessional teams. Perspectively, the results can contribute to the development of quality standards in NH in Germany.

Keywords: Antipsychotics; Interprofessional care; Medication safety; Nursing home; Potentially inappropriate medication; Quality management.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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