QI intervention aids medication safety for elderly in ER

(HealthDay)—A quality improvement initiative that combines education, electronic clinical decision support, and individual provider feedback can positively influence prescribing behavior and improve medication safety for older adults in the emergency department, according to a study published online April 7 in the Journal of the American Geriatrics Society.

Melissa Stevens, M.D., from Emory University in Atlanta, and colleagues evaluated the effectiveness and sustainability of the EQUiPPED quality improvement initiative to reduce the use of potentially inappropriate medications (PIMs), as defined by the American Geriatrics Society 2012 Beers Criteria, prescribed to older veterans at the time of emergency department discharge. Patients discharged six months prior to the first EQUiPPED intervention and for at least 12 months following the final EQUiPPED intervention were compared.

The researchers found that all four sites showed a significant and sustained reduction in use of PIMs from the pre-EQUiPPED period to the post-EQUiPPED period (site one: from 11.9 to 5.1 percent [P < 0.0001]; site two: 8.2 to 4.5 percent [P < 0.0001]; site three: 8.9 to 6.1 percent [P = 0.0007]; site four: 7.4 to 5.7 percent [P = 0.04]).

"These results suggest a multicomponent program to influence provider prescribing behavior leads to safer prescribing for older adults discharged from the emergency department and is sustainable across multiple Veterans Affairs emergency department sites," the authors write.

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