APPROPRIATE PRESCRIBING FOR OLDER PEOPLE: A NEW TOOL FOR THE GENERAL PRACTITIONER
E. Lenaerts, F. De Knijf, B. Schoenmakers
J Frailty Aging 2013;2(1):8-14
Background: Appropriate prescribing for older people is a challenge. General practitioners (GPs) are aware of their key position in relation to prescribing practice in the elderly. However, they often feel powerless and report a need for simple GP friendly tools to assess and support their prescribing practice. Objectives: In this study such a tool is developed: the Appropriate Medication for Older people-tool (AMO-tool). The purpose of the study is to investigate whether GPs consider the use of the AMO-tool to be practically feasible and resulting in more appropriate prescribing. Design: This pilot study with an interventional design was conducted over a period of six months. Setting: The study was conducted in nursing homes visited by GPs. Participants: The studied population consisted of nine GPs and 67 nursing home residents. Intervention: The intervention consisted of the use of the AMO-tool. Measurements: The Short Form (SF)-12 questionnaire was administered to the patients. Patients' medication lists were recorded. The GPs completed a semi-quantitative questionnaire on their experiences with the AMO-tool. A descriptive qualitative and semi-quantitative analysis was carried out on the GP questionnaire. The results of the SF-12 questionnaires and medication lists were analysed quantitatively. A multivariate analysis was carried out. Results: In the perception of GPs, applying the AMO-tool to medication lists of nursing home residents was feasible and resulted in more appropriate prescribing. A slight reduction was recorded in the number of medications prescribed. Self-reported well-being improved and rose in parallel with the number of medication changes. Conclusion: According to GPs, the AMO-tool offers GPs the support in their prescribing practice. Changes are made to medication lists and improvements occur in patients' self-reported well-being. Future research should objectify the appropriateness of prescriptions before and after using the tool. Furthermore, it should investigate the possible causal relationship between the use of the AMO-tool, an increase in appropriateness of medication lists and an improvement of general well-being.
E. Lenaerts ; F. De Knijf ; B. Schoenmakers (2013): Appropriate prescribing for older people: a new tool for the general practitioner. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2013.2