The effect of biannual medication reviews on the appropriateness of psychotropic drug use for neuropsychiatric symptoms in patients with dementia: a randomised controlled trial.

Autor:	van der Spek K; Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen Huispost 117 ELG, PO Box 9101, 6500 HB Nijmegen, The Netherlands., Koopmans RTCM; Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen Huispost 117 ELG, PO Box 9101, 6500 HB Nijmegen, The Netherlands.; Joachim and Anna, Centre for Specialized Geriatric care, Nijmegen, Radboudumc Alzheimer Centrum, Nijmegen., Smalbrugge M; Department of General Practice and Elderly Care Medicine/EMGO+ Institute for Health and Care Research, VU Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands., Nelissen-Vrancken MHJMG; Dutch Institute for Rational Use of Medicine, PO Box 3089, 3502 GB Utrecht, The Netherlands., Wetzels RB; Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen Huispost 117 ELG, PO Box 9101, 6500 HB Nijmegen, The Netherlands., Smeets CHW; Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen Huispost 117 ELG, PO Box 9101, 6500 HB Nijmegen, The Netherlands., de Vries E; Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen Huispost 117 ELG, PO Box 9101, 6500 HB Nijmegen, The Netherlands., Teerenstra S; Department for Health Evidence, Group Biostatistics, Radboud Institute of Health Sciences, Radboud University Medical Centre, Nijmegen Huispost 133 HEV, PO Box 9101, 6500 HB Nijmegen, The Netherlands., Zuidema SU; Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Centre Groningen, HPC FA21, PO Box 196, 9700 AD Groningen., Gerritsen DL; Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen Huispost 117 ELG, PO Box 9101, 6500 HB Nijmegen, The Netherlands.; Radboudumc Alzheimer Centrum, Nijmegen.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2018 May 01; Vol. 47 (3), pp. 430-437.
DOI:	10.1093/ageing/afy001
Abstrakt:	Objective: We studied the efficacy of biannual structured medication reviews to improve the appropriateness of psychotropic drug (PD) prescriptions for neuropsychiatric symptoms (NPS) in nursing home patients with dementia. Study Design and Setting: In this randomised controlled trial, the intervention encompassed a structured multidisciplinary medication review by physician, pharmacist and nurse. During this 18-month study, the patient's medical files were assessed every 6 months. The primary outcome was the appropriateness of PD prescriptions defined by the Appropriate Psychotropic drug use In Dementia (APID) index sum score, lower scores indicating more appropriate use. Results: At baseline, 380 patients were included, of which 222 were randomised to the intervention group. Compared to the control group, the APID index sum score in the intervention group improved significantly for all PD prescriptions (-5.28, P = 0.005). Conclusion: We advise the implementation of a structured, repeated medication review with the essential roles of pharmacist, physician and nurse, into daily practice. This work was supported and funded by the Netherlands Organisation for Health Research and Development (ZonMw). Netherlands Trial Register (NTR3569).
Databáze:	MEDLINE
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