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Teaching physicians the GPGP method promotes deprescribing in both inpatient and outpatient settings

机译：教学医师GPGP方法促进住院患者和门诊设置中的贬低

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Background In complex older patients, inappropriate medication use and polypharmacy (IMUP) are commonplace and increasing exponentially. Reducing IMUP is a challenge in multiple clinical contexts, including acute admission and family practice, due to several key barriers. In the global effort against this epidemic, educational programs geared toward changing physicians’ prescribing patterns represent an important means of promoting deprescribing. Methods This is a nonrandomized, controlled interventional study investigating polypharmacy outcomes and prescribing patterns in patients whose physicians were trained in the Good Palliative-Geriatric Practice (GPGP) method, an algorithm for the reduction of polypharmacy, with patients whose physicians were not. Training involved a one-time, full-day workshop led by a senior geriatrician. Two separate settings were examined. In the inpatient setting, one internal medicine ward was trained and compared with another ward which was not trained. In the family practice setting, 28 physicians were trained and compared with practices of 15 physicians not trained. Patients were above the age of 70, representative of the general geriatric population, and not terminally ill. Results In the inpatient arm, the intervention group ( n?=?100) experienced a decrease in medications prescribed from admission to discharge of 18.5%, compared with a decrease of 1.9% in the control group ( n?=?100, difference between groups p? Conclusions A one-time educational intervention based on GPGP can change prescribing patterns in both outpatient and inpatient settings leading to a moderate reduction in polypharmacy. Future work should focus on longitudinal interventions, and longer-term clinical outcomes such as morbidity, mortality, and quality of life.
机译：背景技术在复杂的老年患者中，不适当的药物用途和多酚省（IMUP）是常见的并且呈指数增加。减少IMUP是多种临床背景下的挑战，包括急性入学和家庭惯例，由于几个关键的障碍。在全球对抗这种流行病的努力中，朝着改变医生的处方模式的教育计划代表了促进贬低的重要手段。方法这是一种非扫描的受控介入研究调查多药物结果和在医生培训的患者中的处方模式，在良好的姑息治疗（GPGP）方法中，一种用于减少PolyPharcacency的算法，其医生没有。培训涉及由高级老年人领导的一次性，全日研讨会。检查了两个单独的设置。在住院性环境中，一位内部医学病房培训并与另一个未培训的病房进行比较。在家庭练习环境中，培训28名医生，并与未经培训的15名医生的实践进行比较。患者高于70岁，代表普通老年人口，而不是终身病。导致住院臂，干预组（N？=α100）在对照组中减少18.5％的入学票据的药物减少（n？=？100，之间的差异群体P？结论基于GPGP的一次性教育干预可以改变门诊和住院环境中的处方模式，导致复数减少。未来的工作应专注于纵向干预，以及月发病率的长期临床结果，如发病率，死亡率和生活质量。

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