Improving Medication Safety in Psychiatry: A Controlled Intervention Study of Nurse Involvement in Avoidance of Potentially Inappropriate Prescriptions

Ann Lykkegaard Soerensen, Marianne Lisby, Lars Peter Nielsen, Birgitte Klindt Poulsen, Jan Mainz

Research output: Contribution to journalJournal articleResearchpeer-review

7 Citations (Scopus)

Abstract

The aim of this controlled, before-and-after study in the Department of Psychiatry in a university hospital in Denmark, was to examine the potential effects and characteristics of nurses reviewing psychiatric patients' medication records to identify potentially inappropriate prescriptions (PIPs). The control group and the intervention group each consisted of two bed units chosen based on patients' diagnoses and age categories. There were 396 patients (age≥18 years) included in the study. Senior clinical pharmacology physicians performed medication reviews for all patients in the study; these medication reviews were considered gold standard. The intervention group: nurses were given a pharmacology course after which the nurses reviewed medication lists and subsequently conferred any identified PIPs with physicians. The control group: medication was reviewed as usual and nurses did not participate. Primary outcome measure was the potential difference in PIPs between the control group and the intervention group, analysed in two ways: 1) difference in mean number of PIPs, and 2) difference in number of patients exposed to ≥1 PIP, using regression analysis with an approximated difference-in-difference (DID) approach. Secondary outcome measure: characteristics of PIPs where physicians responded to nurse-identified PIPs. The DID between intervention group and control group for mean number of PIPs per patient was -0.23 (-1.07 to 0.60) and for number of patients receiving ≥1 PIP the odds ratio was 0.61 (0.25 to 1.46). Physicians changed most prescriptions in the category interaction between drugs. Nurses could not significantly reduce the prevalence of PIPs for psychiatric patients. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalBasic & Clinical Pharmacology & Toxicology
Volume123
Issue number2
Pages (from-to)174-181
Number of pages8
ISSN1742-7835
DOIs
Publication statusPublished - 2018

Bibliographical note

© 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Keywords

  • Adult
  • Denmark
  • Drug Interactions
  • Drug Utilization Review/statistics & numerical data
  • Education, Nursing
  • Female
  • Hospitals, Psychiatric/statistics & numerical data
  • Humans
  • Inappropriate Prescribing/prevention & control
  • Male
  • Middle Aged
  • Nurses/organization & administration
  • Pharmacology/education
  • Potentially Inappropriate Medication List/statistics & numerical data
  • Practice Patterns, Physicians'/statistics & numerical data
  • Professional Role
  • Program Evaluation
  • Psychiatry/methods
  • Regression Analysis

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