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Am J Geriatr Psychiatry 16:621-632, August 2008
© 2008 American Association for Geriatric Psychiatry
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Special Articles

Psychotropic Prescribing in Long-Term Care Facilities: Impact of Medication Reviews and Educational Interventions

Prasad S. Nishtala, M.Pharm., Andrew J. McLachlan, Ph.D., J. Simon Bell, Ph.D., and Timothy F. Chen, Ph.D.

From the Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia (PSN, AJM, JSB, TFC); Centre for Education and Research on Ageing, Concord Hospital, Concord, New South Wales, Australia (AJM); and the Faculty of Pharmacy, The University of Helsinki, Helsinki, Finland (JSB).

The objective of this literature review was to evaluate the evidence pertaining to the impact of medication reviews and/or educational interventions on psychotropic drug use in long-term care facilities. A computerized search was conducted using MEDLINE, Cochrane Central Register of Control Trials, CINAHL, EMBASE, International Pharmaceutical Abstracts and PsycINFO, from January 1980 to April 2007. Controlled studies or randomized controlled studies were included for review. The authors identified 26 studies evaluating the impact of medication reviews and/or educational interventions on psychotropic drug use in long-term care facilities. Eleven studies met the inclusion criteria for this review and the data from six of these studies were included in a meta-analysis. The pooled odds ratio (OR) from five studies on hypnotic prescribing showed a decrease in use postintervention (OR = 0.57, 95% confidence intervals [CI] = 0.41–0.79). The pooled OR from five studies on prevalence of antipsychotic prescribing postintervention was not significant (OR = 0.81, 95% CI = 0.63–1.04). Medication reviews and/or educational interventions are effective at reducing psychotropic drug prescribing. However, research on the benefits of these interventions in reducing psychotropic drug use on total health care costs and resident health outcomes is lacking.

Key Words: Long-term care facilities • psychotropic drugs • medication review • educational interventions






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