Evaluation of patient outcomes in an area where prescribing of anticholinergic antidepressants was influenced by academic detailing.

Autor: van Eijk ME; Dutch Institute for the Effective Use of Medication DGV, 3502 GB Utrecht, The Netherlands. m.e.c.vanEijk@pharm.uu.n, Belitser SV, Porsius AJ, de Boer A
Jazyk: angličtina
Zdroj: Pharmacy world & science : PWS [Pharm World Sci] 2002 Aug; Vol. 24 (4), pp. 144-8.
DOI: 10.1023/a:1019559301580
Abstrakt: Objective: To evaluate, on a patient level, the effect of a "physician-level intervention" that successfully reduced the incidence of anticholinergic antidepressant prescribing.
Design: Cross-sectional surveys with questionnaires sent before and after intervention.
Setting: Additional study in an RCT to reduce the prescribing of highly anticholinergic antidepressants in the elderly in the South Holland Islands.
Participants: Elderly patients (age 60-95 years) who used antidepressants in 1995 and 1996 in our research area according to a health insurance prescription database.
Main Outcome Measures: Prevalence of adverse events related to antidepressant use, severity of depression and quality of life were compared in users living in the intervention and control areas.
Results: Prior to our intervention we sent 2,359 questionnaires of which we could use 827 (35%) for analysis. At baseline, there were no statistically significant differences between the intervention and control areas. After the intervention 3,375 questionnaires were sent, of which 939 (28%) could be used. The occurrence of "dry mouth" and "coughing" and the "amount of pain" were lower in the intervention area compared to the control area (p < 0.05).
Conclusion: We found no indications that adverse events, severity of depression or quality of life were changed in an unfavourable direction, when comparing patients inside and outside the intervention area.
Databáze: MEDLINE
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