Prevalence of potentially inappropriate prescriptions (PIPs) for patients aged ≥70 years at baseline by the various PIP criteria and changed prescribing due to the educational intervention
| Intervention group, n = 250 GPs | Control group, n = 199 GPs | Changes due to the interventionb | ||||
|---|---|---|---|---|---|---|
| Absolute change, | Relative change, | |||||
| Baseline % | Change %a | Basline % | Change %a | % (95% CI) | % (95% CI) | |
| Tricyclic antidepressants | 2.4 | −0.4 | 2.1 | 0.0 | −0.4 (−0.8 to −0.0) | −16.7 (−32.8 to 0.0) |
| Antihistamines | 2.6 | −0.4 | 2.4 | 0.0 | −0.4 (−0.9 to 0.1) | −15.3 (−34.5 to 3.8) |
| Antipsychotics | 2.9 | −0.8 | 2.5 | 0.0 | −0.7 (−1.2 to −0.3) | −24.1 (−41.3 to −10.3) |
| Long-acting benzodiazepines | 4.7 | −1.2 | 4.7 | −0.7 | −0.4 (−1.1 to 0.2) | −8.5 (−23.4 to 4.3) |
| Carisoprodol | 1.0 | −0.3 | 1.1 | −0.3 | −0.1 (−0.3 to 0.2) | −10.0 (−30.0 to 20.0) |
| Strong analgesics | 1.4 | −0.4 | 0.9 | −0.2 | −0.2 (−0.5 to 0.1) | −14.3 (−35.7 to 7.1) |
| Theophylline by mouth | 0.5 | −0.1 | 0.6 | −0.2 | 0.1 (−0.1 to 0.2) | 20.0 (−20.0 to 40.0) |
| Beta-blocker + verapamil or diltiazem | 0.3 | −0.1 | 0.3 | −0.1 | 0.0 (−0.3 to 0.1) | − |
| NSAID + warfarin | 0.6 | −0.3 | 0.5 | −0.0 | −0.2 (−0.4 to −0.1) | −33.3 (−66.6 to −16.7) |
| NSAID + ACE inhibitorc | 3.5 | −0.4 | 3.5 | −0.2 | −0.3 (−0.8 to 0.3) | −8.5 (−15.44 to 5.8) |
| NSAID + SSRI | 0.8 | −0.2 | 0.9 | −0.1 | −0.1 (−0.3 to 0.1) | −12.5 (−37.5 to 0.0) |
| NSAID + diuretic | 3.9 | −0.5 | 3.8 | −0.0 | −0.5 (−1.1 to 0.1) | −12.8 (−28.2 to 2.6) |
| ≥3 psychotropic psychotropic drugsd | 2.5 | 0.2 | 2.7 | 0.2 | 0.1 (−0.4 to 0.2) | −4.0 (−16.0 to 8.0) |
| Total PIPs per 100 patients aged ≥70 years | 27.3 | −4.9 | 25.8 | −1.6 | −3.3 (−5.6 to −0.9) | −12.1 (−16.8 to−6.9) |
ACE = angiotensin-converting enzyme. COX = cyclooxygenase. NSAID = non-steroidal antiinflammatory drug. SSRI = selective serotonin reuptake inhibitor.
↵a The changes of prescribing are adjusted for baseline differences and clustering effects.
↵b Absolute change denotes the difference between proportions before and after the intervention, while relative change denotes the absolute change as % of baseline proportion. Figures are adjusted for baseline differences and clustering effects on the peer CME group level.
↵c Also including COX-2 inhibitors and angiotensin receptor blockers.
d Concurrent use of three or more of opiate-containing analgesics, hypnotics, tranquillisers, antipsychotics, or antidepressants.