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Titolo:
Educational program for nursing home physicians and staff to reduce use ofnon-steroidal anti-inflammatory drugs among nursing home residents - A randomized controlled trial
Autore:
Stein, CM; Griffin, MR; Taylor, JA; Pichert, JW; Brandt, KD; Ray, WA;
Indirizzi:
Vanderbilt Univ, Med Ctr, Dept Prevent Med, Med Ctr N,Sch Med, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 N,Sch Med, Nashville, TN 37232 USA Vanderbilt Univ, Sch Med, Dept Med, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 Dept Med, Nashville, TN 37232 USA Vanderbilt Univ, Sch Med, Ctr Geriatr Res Educ & Clin, Nashville, TN 37232USA Vanderbilt Univ Nashville TN USA 37232 duc & Clin, Nashville, TN 37232USA Indiana Univ, Sch Med, Div Rheumatol, Indianapolis, IN USA Indiana Univ Indianapolis IN USA ed, Div Rheumatol, Indianapolis, IN USA
Titolo Testata:
MEDICAL CARE
fascicolo: 5, volume: 39, anno: 2001,
pagine: 436 - 445
SICI:
0025-7079(200105)39:5<436:EPFNHP>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; PEPTIC-ULCER DISEASE; GASTROINTESTINAL-DISEASE; ELDERLY PERSONS; OSTEOARTHRITIS; PAIN; ACETAMINOPHEN; QUESTIONNAIRE; MANAGEMENT; KNEE;
Keywords:
pharmacoepidemiology; intervention studies; pain; aged; anti-inflammatory agents; non-steroidal;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Ray, WA Vanderbilt Univ, Med Ctr, Dept Prevent Med, Med Ctr N,Sch Med, A-1124, Nashville, TN 37232 USA Vanderbilt Univ A-1124 Nashville TN USA 37232 hville, TN 37232 USA
Citazione:
C.M. Stein et al., "Educational program for nursing home physicians and staff to reduce use ofnon-steroidal anti-inflammatory drugs among nursing home residents - A randomized controlled trial", MED CARE, 39(5), 2001, pp. 436-445

Abstract

CONTENT. The risk for serious gastrointestinal complications due to nonsteroidal antiinflammatory drugs (NSAIDs) is high in the elderly. Acetaminophen-based regimens are safer and may be as effective as NSAIDs for the treatment of osteoarthritis in many patients. OBJECTIVE. TO determine the effects of an educational program on NSAID useand clinical outcomes in nursing homes,DESIGN AND SETTING. Randomized controlled study, Ten pairs of Tennessee nursing homes with greater than or equal to8% of residents receiving NSAIDs were randomized to intervention or control. SUBJECTS, Nursing home residents (intervention n = 76 and control n = 71) aged 65 years and older taking NSAIDs regularly. INTERVENTIONS. An educational program for physicians and nursing home staff that included the risks and benefits of NSAIDs in the elderly and an algorithm that substituted acetaminophen, topical agents, and nonpharmacologic measures for the treatment of noninflammatory musculoskeletal pain. Intervention and control subjects were assessed at baseline and 3 months later,MAIN OUTCOME MEASURES. Differences in NSAID and acetaminophen use, and pain, function, and disability scores in intervention and control nursing homesubjects. RESULTS. The intervention was effective resulting in markedly decreased NSAID use and increased acetaminophen use. Mean number of days of NSAID use in the 7 day periods before the baseline and 3 month assessments decreased from 7.0 to 1.9 days in intervention home subjects compared with a decrease from 7.0 to 6.2 days in control homes (P = 0.0001). Acetaminophen use in the 7 days immediately before the 3 month assessment increased by 3.1 days inintervention home subjects compared with 0.31 days in control homes (P = 0.0001). A similar proportion of subjects in control (32.5%) and intervention (35.4%) groups had worsening of their arthritis pain score (P = 0.81). CONCLUSIONS. An educational intervention effectively reduced NSAID use in nursing homes without worsening of arthritis pain.

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Documento generato il 25/01/20 alle ore 09:26:30