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Author Notes:

Corresponding Author: Jason M. Moss, Geriatric Research Education and Clinical Center, Durham VA Medical Center, 508 Fulton St. (GRECC/182), Durham, NC 27705, USA. jason.moss@va.gov

The authors would like to acknowledge Sherman Lee for editorial support.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Research Funding:

Funding was provided by the Department of Veterans Affairs Office of Geriatrics and Extended Care T-21 initiative (G508-1 and G521-5).

This work was also supported in part by the Center of Innovation for Health Services Research in Primary Care (CIN 13-410) at the Durham VA Health Care System.

Dr Vaughan is supported by a Rehabilitation R&D CDA-2 award from the Department of Veterans Affairs 1 IK2 RX000747-01.

Dr Hastings is supported by the Duke Claude D. Pepper Older Americans Independence Center NIA grant (P30AG028716).

Keywords:

  • academic detailing
  • elderly
  • potentially inappropriate medications

An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department

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Journal Title:

Journal of Pharmacy Practice

Volume:

Volume 32, Number 2

Publisher:

, Pages 167-174

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective: To evaluate the impact of an academic detailing intervention delivered as part of a quality improvement project by a physician–pharmacist pair on (1) self-reported confidence in prescribing for older adults and (2) rates of potentially inappropriate medications (PIMs) prescribed to older adults by physician residents in a Veteran Affairs emergency department (ED). Methods: This quality improvement project at a single site utilized a questionnaire that assessed knowledge of Beers Criteria, self-perceived barriers to appropriate prescribing in older adults, and self-rated confidence in ability to prescribe in older adults which was administered to physician residents before and after academic detailing delivered during their emergency medicine rotation. PIM rates in the resident cohort who received the academic detailing were compared to residents who did not receive the intervention. Results: Sixty-three residents received the intervention between February 2013 and December 2014. At baseline, approximately 50% of the residents surveyed reported never hearing about nor using the Beers Criteria. A significantly greater proportion of residents agreed or strongly agreed in their abilities to identify drug–disease interactions and to prescribe the appropriate medication for the older adult after receiving the intervention. The resident cohort who received the educational intervention was less likely to prescribe a PIM when compared to the untrained resident cohort with a rate ratio of 0.73 (P <.0001). Conclusion: Academic detailing led by a physician–pharmacist pair resulted in improved confidence in physician residents’ ability to prescribe safely in an older adult ED population and was associated with a statistically significant decrease in PIM rates.

Copyright information:

© The Author(s) 2017.

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