Development and use of a computer program to detect potentially inappropriate prescribing in older adults residing in Canadian long-term care facilities

Παπαϊωάννου, Αλεξάνδρα; Bédard, Michel; Campbell, Glenda; Dubois, Sacha; Ferko, Nicole; Heckman, George A.; Flett, Norman

doi:10.1186/1471-2318-2-5

Cited by 10 publications

(8 citation statements)

References 21 publications

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“…Explicit criteria lists, such as those developed by Beers and McLeod, define inappropriate prescription according to the drug overall risk-benefit profile for elderly patients. These lists were previously used in studies examining inappropriate prescribing in elderly populations [3,5,6,11,15,27-30] and undergo a continuous process of revision and updating to reflect the most current clinical information on the risks and benefits of medications [31]. …”

Section: Discussionmentioning

confidence: 99%

“…As in previous studies [15], we did not abstract information on diagnoses from the patients charts and drug prescriptions were considered as surrogates for disease conditions. Thus, the explicit criteria used in this study apply to general circumstances, but may not be applicable to specific cases, since they do not consider clinical information.…”

Section: Discussionmentioning

confidence: 99%

“…A growing body of evidence suggests that clinical pharmacy and multidisciplinary team interventions can modify suboptimal prescribing in older patients. Modern data management [15,41] and use of the best clinical evidence could help practitioners improve the management of complex cases [40,42]. Recent studies in long-term care settings showed that physician or pharmacist interventions reduce PIPs [1,12,16,43], while a clinical review program of prescriptions for community-dwelling patients conducted by a team of physicians, pharmacists and nurses did not seem to improve prescribing practices [44].…”

Section: Discussionmentioning

confidence: 99%

“…A 1995 study of community-dwelling and institutionalized older patients reported large variations in PIPs among provinces, ranging from 4.8% in the prairies to 12.8% in Quebec [9]. More recently, the prevalence of PIPs in long-term care patients in Ontario was reported to range between 14.9% and 20.8% [15-17]. In Quebec, a 1990 retrospective database survey of 63,268 older Medicare patients reported that 45.6% of non-institutionalized patients received high-risk prescriptions of questionable appropriateness [8], while a recent survey of 3,400 elderly patients in the Quebec general population reported that 6.5% had a potentially inappropriate prescription (PIP) [18].…”

Section: Introductionmentioning

confidence: 99%

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Potentially inappropriate prescriptions for older patients in long-term care

et al. 2004

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BackgroundInappropriate medication use is a major healthcare issue for the elderly population. This study explored the prevalence of potentially inappropriate prescriptions (PIPs) in long-term care in metropolitan Quebec.MethodsA cross sectional chart review of 2,633 long-term care older patients of the Quebec City area was performed. An explicit criteria list for PIPs was developed based on the literature and validated by a modified Delphi method. Medication orders were reviewed to describe prescribing patterns and to determine the prevalence of PIPs. A multivariate analysis was performed to identify predictors of PIPs.ResultsAlmost all residents (94.0%) were receiving one or more prescribed medication; on average patients had 4.8 prescribed medications. A majority (54.7%) of treated patients had a potentially inappropriate prescription (PIP). Most common PIPs were drug interactions (33.9% of treated patients), followed by potentially inappropriate duration (23.6%), potentially inappropriate medication (14.7%) and potentially inappropriate dosage (9.6%). PIPs were most frequent for medications of the central nervous system (10.8% of prescribed medication). The likelihood of PIP increased significantly as the number of drugs prescribed increased (odds ratio [OR]: 1.38, 95% confidence interval [CI]: 1.33 – 1.43) and with the length of stay (OR: 1.78, CI: 1.43 – 2.20). On the other hand, the risk of receiving a PIP decreased with age.ConclusionPotentially inappropriate prescribing is a serious problem in the highly medicated long-term care population in metropolitan Quebec. Use of explicit criteria lists may help identify the most critical issues and prioritize interventions to improve quality of care and patient safety.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Potentially inappropriate prescriptions for older patients in long-term care

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“…In addition, perfectionism is a complex personality trait, characterized by one's high performance standards and eagerness for flawlessness. It is accompanied by tendencies towards critical evaluation of behaviors and negative cognition, involving a negative sense that things are not complete or correct (11,12).…”

Section: Introductionmentioning

confidence: 99%

Role of Perfectionism and Body Image in the Prediction of Body Dysmorphic Disorder Symptoms

Arji¹,

Borjali²,

Sohrābi³

et al. 2016

Avicenna J Neuro Psycho Physiology

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Background: The prevalence of body dysmorphic disorder (BDD) has been reported to increase in recent decades. Therefore, scientific studies should be performed to specify psychological variables, which may contribute to the etiology of this disorder. In this study, we examined the role of body image and perfectionism in predicting BDD symptoms among students. Objective: The aim of this survey was to investigate the role of body image and perfectionism in the prediction of BDD symptoms. Methods: This cross sectional study was performed in 2016 on a sample, including 351 students of Hamadan University of Medical Sciences, who were selected based on the Morgan formula and multistage cluster random sampling. The participants completed the Yale-Brown obsessive compulsive scale modified for BDD (BDD-YBOCS), multidimensional body-self relations questionnaire (MB-SRQ), and Besharat's Tehran multidimensional perfectionism scale (TMPS). The collected data were analyzed by Pearson's correlation test and stepwise regression analysis. Results and Conclusions:The results of stepwise regression analysis showed that perfectionism and body image could significantly predict BDD symptoms (P < 0.001). Therefore, these variables can be important in the promotion of students' health.

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The Time to Act Is Now

Steel¹

2004

Arch Intern Med

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Development and use of a computer program to detect potentially inappropriate prescribing in older adults residing in Canadian long-term care facilities

Abstract: Background: Inappropriate prescribing has been estimated to be as high as 40% in long-term care. The purpose of this study was to develop a computer program that identifies potentially inappropriate drug prescriptions and to test its reliability.

Cited by 10 publications

References 21 publications

Potentially inappropriate prescriptions for older patients in long-term care

Potentially inappropriate prescriptions for older patients in long-term care

Role of Perfectionism and Body Image in the Prediction of Body Dysmorphic Disorder Symptoms

The Time to Act Is Now

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