The PROMISING Project: A Pilot Study to Improve Geriatric Care Through a Pharmacist-Led Psychotropic Stewardship Program
Background and objective Psychotropic medications are frequently prescribed during acute care, even in older patients. They represent a risk for inappropriate long-term use and increase the overall risk of morbidity and mortality in this population. Our project aimed to evaluate the feasibility of a...
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| Veröffentlicht in: | Drugs & aging 2023-11, Vol.40 (11), p.1037-1045 |
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| creator | d’Amours, Marie Ettis, Farah Ginefri, Lauriane Lim, Johnny Lin Poo Yuan, Angela-Sinlan Fontaine, Jennifer Wazzan, Dana Williamson, David Dagenais-Beaulé, Vincent |
| description | Background and objective
Psychotropic medications are frequently prescribed during acute care, even in older patients. They represent a risk for inappropriate long-term use and increase the overall risk of morbidity and mortality in this population. Our project aimed to evaluate the feasibility of a psychotropic medication stewardship program led by pharmacists.
Methods
We conducted a prospective, observational pilot study in patients aged 75 years and older, admitted to a surgical unit with at least one active prescription of a psychotropic medication (antipsychotic, benzodiazepine or non-benzodiazepine receptor agonist). Each psychotropic medication was assessed for potential deprescription, and if eligible, a recommendation from the stewardship pharmacist was made to the medical team.
Results
Among 183 patients, 93.4% were eligible for a potential deprescription. A total of 298 prescriptions were evaluated by the stewardship pharmacists, of which 57.7% were antipsychotics, 22.8% were benzodiazepines and 19.5% were non-benzodiazepine receptor agonists. Most of the assessed prescriptions were started during current hospitalization (62.7%). The median time required for the intervention per patient was 17 min 30 s. The stewardship pharmacists made 192 suggestions for 258 eligible prescriptions, with 69.8% being deprescription recommendations. Of all the deprescription suggestions, 75.4% were accepted by the medical team and 84.8% of those accepted persisted at discharge.
Conclusion
The implementation of a pharmacist-led psychotropic medication stewardship program on surgical units in our hospital is feasible and is a promising approach to improve geriatric care. |
| doi_str_mv | 10.1007/s40266-023-01063-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2883015996</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2883015996</sourcerecordid><originalsourceid>FETCH-LOGICAL-c270t-2b0f8b7c4d9bae01be55a9b385e958cccb570ed9d060d8226ed4fab5d06749fb3</originalsourceid><addsrcrecordid>eNp9kF9LwzAUxYsoOKdfwKeAz9Gb9G98G0NnYbriJvgW0jRdO9ZlJqm6fXq7VfDNp3sv_M45l-N51wRuCUB8ZwOgUYSB-hgIRD7en3gDQmKGCYvY6XEHTCl7P_curF0BQEQpGXjfi0qh7HX2nM7TlwnKjF4p6e7RCGX1Wjs0d22xQ06jtNka_anQRJlaOFNLNBZGoUVldLuskEBZJUwjZG0dnqoCZXYnK-2M3nbo3KkvYQpb1dtDxNKI5tI7K8XaqqvfOfTeHh8W4yc8nU3S8WiKJY3BYZpDmeSxDAqWCwUkV2EoWO4noWJhIqXMwxhUwQqIoEgojVQRlCIPuzsOWJn7Q--m9-3e_2iVdXylW7PpIjlNEh9IyFjUUbSnpNHWGlXyrakbYXacAD80zPuGedcwPzbM953I70W2gzdLZf6s_1H9AD0-f_A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2883015996</pqid></control><display><type>article</type><title>The PROMISING Project: A Pilot Study to Improve Geriatric Care Through a Pharmacist-Led Psychotropic Stewardship Program</title><source>SpringerLink Journals - AutoHoldings</source><creator>d’Amours, Marie ; Ettis, Farah ; Ginefri, Lauriane ; Lim, Johnny ; Lin Poo Yuan, Angela-Sinlan ; Fontaine, Jennifer ; Wazzan, Dana ; Williamson, David ; Dagenais-Beaulé, Vincent</creator><creatorcontrib>d’Amours, Marie ; Ettis, Farah ; Ginefri, Lauriane ; Lim, Johnny ; Lin Poo Yuan, Angela-Sinlan ; Fontaine, Jennifer ; Wazzan, Dana ; Williamson, David ; Dagenais-Beaulé, Vincent</creatorcontrib><description>Background and objective
Psychotropic medications are frequently prescribed during acute care, even in older patients. They represent a risk for inappropriate long-term use and increase the overall risk of morbidity and mortality in this population. Our project aimed to evaluate the feasibility of a psychotropic medication stewardship program led by pharmacists.
Methods
We conducted a prospective, observational pilot study in patients aged 75 years and older, admitted to a surgical unit with at least one active prescription of a psychotropic medication (antipsychotic, benzodiazepine or non-benzodiazepine receptor agonist). Each psychotropic medication was assessed for potential deprescription, and if eligible, a recommendation from the stewardship pharmacist was made to the medical team.
Results
Among 183 patients, 93.4% were eligible for a potential deprescription. A total of 298 prescriptions were evaluated by the stewardship pharmacists, of which 57.7% were antipsychotics, 22.8% were benzodiazepines and 19.5% were non-benzodiazepine receptor agonists. Most of the assessed prescriptions were started during current hospitalization (62.7%). The median time required for the intervention per patient was 17 min 30 s. The stewardship pharmacists made 192 suggestions for 258 eligible prescriptions, with 69.8% being deprescription recommendations. Of all the deprescription suggestions, 75.4% were accepted by the medical team and 84.8% of those accepted persisted at discharge.
Conclusion
The implementation of a pharmacist-led psychotropic medication stewardship program on surgical units in our hospital is feasible and is a promising approach to improve geriatric care.</description><identifier>ISSN: 1170-229X</identifier><identifier>EISSN: 1179-1969</identifier><identifier>DOI: 10.1007/s40266-023-01063-z</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Antibiotics ; Antipsychotics ; Benzodiazepines ; Clinical outcomes ; Drug stores ; Electronic health records ; Geriatrics ; Geriatrics/Gerontology ; Hospitalization ; Hospitals ; Internal Medicine ; Medicine ; Medicine & Public Health ; Mortality ; Older people ; Original Research Article ; Patients ; Pharmacology/Toxicology ; Pharmacotherapy ; Pilot projects ; Prescriptions ; Psychotropic drugs ; Variance analysis</subject><ispartof>Drugs & aging, 2023-11, Vol.40 (11), p.1037-1045</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>Copyright Springer Nature B.V. Nov 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c270t-2b0f8b7c4d9bae01be55a9b385e958cccb570ed9d060d8226ed4fab5d06749fb3</cites><orcidid>0000-0003-3360-4831 ; 0000-0002-8526-857X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40266-023-01063-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40266-023-01063-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids></links><search><creatorcontrib>d’Amours, Marie</creatorcontrib><creatorcontrib>Ettis, Farah</creatorcontrib><creatorcontrib>Ginefri, Lauriane</creatorcontrib><creatorcontrib>Lim, Johnny</creatorcontrib><creatorcontrib>Lin Poo Yuan, Angela-Sinlan</creatorcontrib><creatorcontrib>Fontaine, Jennifer</creatorcontrib><creatorcontrib>Wazzan, Dana</creatorcontrib><creatorcontrib>Williamson, David</creatorcontrib><creatorcontrib>Dagenais-Beaulé, Vincent</creatorcontrib><title>The PROMISING Project: A Pilot Study to Improve Geriatric Care Through a Pharmacist-Led Psychotropic Stewardship Program</title><title>Drugs & aging</title><addtitle>Drugs Aging</addtitle><description>Background and objective
Psychotropic medications are frequently prescribed during acute care, even in older patients. They represent a risk for inappropriate long-term use and increase the overall risk of morbidity and mortality in this population. Our project aimed to evaluate the feasibility of a psychotropic medication stewardship program led by pharmacists.
Methods
We conducted a prospective, observational pilot study in patients aged 75 years and older, admitted to a surgical unit with at least one active prescription of a psychotropic medication (antipsychotic, benzodiazepine or non-benzodiazepine receptor agonist). Each psychotropic medication was assessed for potential deprescription, and if eligible, a recommendation from the stewardship pharmacist was made to the medical team.
Results
Among 183 patients, 93.4% were eligible for a potential deprescription. A total of 298 prescriptions were evaluated by the stewardship pharmacists, of which 57.7% were antipsychotics, 22.8% were benzodiazepines and 19.5% were non-benzodiazepine receptor agonists. Most of the assessed prescriptions were started during current hospitalization (62.7%). The median time required for the intervention per patient was 17 min 30 s. The stewardship pharmacists made 192 suggestions for 258 eligible prescriptions, with 69.8% being deprescription recommendations. Of all the deprescription suggestions, 75.4% were accepted by the medical team and 84.8% of those accepted persisted at discharge.
Conclusion
The implementation of a pharmacist-led psychotropic medication stewardship program on surgical units in our hospital is feasible and is a promising approach to improve geriatric care.</description><subject>Antibiotics</subject><subject>Antipsychotics</subject><subject>Benzodiazepines</subject><subject>Clinical outcomes</subject><subject>Drug stores</subject><subject>Electronic health records</subject><subject>Geriatrics</subject><subject>Geriatrics/Gerontology</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Older people</subject><subject>Original Research Article</subject><subject>Patients</subject><subject>Pharmacology/Toxicology</subject><subject>Pharmacotherapy</subject><subject>Pilot projects</subject><subject>Prescriptions</subject><subject>Psychotropic drugs</subject><subject>Variance analysis</subject><issn>1170-229X</issn><issn>1179-1969</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kF9LwzAUxYsoOKdfwKeAz9Gb9G98G0NnYbriJvgW0jRdO9ZlJqm6fXq7VfDNp3sv_M45l-N51wRuCUB8ZwOgUYSB-hgIRD7en3gDQmKGCYvY6XEHTCl7P_curF0BQEQpGXjfi0qh7HX2nM7TlwnKjF4p6e7RCGX1Wjs0d22xQ06jtNka_anQRJlaOFNLNBZGoUVldLuskEBZJUwjZG0dnqoCZXYnK-2M3nbo3KkvYQpb1dtDxNKI5tI7K8XaqqvfOfTeHh8W4yc8nU3S8WiKJY3BYZpDmeSxDAqWCwUkV2EoWO4noWJhIqXMwxhUwQqIoEgojVQRlCIPuzsOWJn7Q--m9-3e_2iVdXylW7PpIjlNEh9IyFjUUbSnpNHWGlXyrakbYXacAD80zPuGedcwPzbM953I70W2gzdLZf6s_1H9AD0-f_A</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>d’Amours, Marie</creator><creator>Ettis, Farah</creator><creator>Ginefri, Lauriane</creator><creator>Lim, Johnny</creator><creator>Lin Poo Yuan, Angela-Sinlan</creator><creator>Fontaine, Jennifer</creator><creator>Wazzan, Dana</creator><creator>Williamson, David</creator><creator>Dagenais-Beaulé, Vincent</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><orcidid>https://orcid.org/0000-0003-3360-4831</orcidid><orcidid>https://orcid.org/0000-0002-8526-857X</orcidid></search><sort><creationdate>20231101</creationdate><title>The PROMISING Project: A Pilot Study to Improve Geriatric Care Through a Pharmacist-Led Psychotropic Stewardship Program</title><author>d’Amours, Marie ; Ettis, Farah ; Ginefri, Lauriane ; Lim, Johnny ; Lin Poo Yuan, Angela-Sinlan ; Fontaine, Jennifer ; Wazzan, Dana ; Williamson, David ; Dagenais-Beaulé, Vincent</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c270t-2b0f8b7c4d9bae01be55a9b385e958cccb570ed9d060d8226ed4fab5d06749fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antibiotics</topic><topic>Antipsychotics</topic><topic>Benzodiazepines</topic><topic>Clinical outcomes</topic><topic>Drug stores</topic><topic>Electronic health records</topic><topic>Geriatrics</topic><topic>Geriatrics/Gerontology</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Older people</topic><topic>Original Research Article</topic><topic>Patients</topic><topic>Pharmacology/Toxicology</topic><topic>Pharmacotherapy</topic><topic>Pilot projects</topic><topic>Prescriptions</topic><topic>Psychotropic drugs</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>d’Amours, Marie</creatorcontrib><creatorcontrib>Ettis, Farah</creatorcontrib><creatorcontrib>Ginefri, Lauriane</creatorcontrib><creatorcontrib>Lim, Johnny</creatorcontrib><creatorcontrib>Lin Poo Yuan, Angela-Sinlan</creatorcontrib><creatorcontrib>Fontaine, Jennifer</creatorcontrib><creatorcontrib>Wazzan, Dana</creatorcontrib><creatorcontrib>Williamson, David</creatorcontrib><creatorcontrib>Dagenais-Beaulé, Vincent</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><jtitle>Drugs & aging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>d’Amours, Marie</au><au>Ettis, Farah</au><au>Ginefri, Lauriane</au><au>Lim, Johnny</au><au>Lin Poo Yuan, Angela-Sinlan</au><au>Fontaine, Jennifer</au><au>Wazzan, Dana</au><au>Williamson, David</au><au>Dagenais-Beaulé, Vincent</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The PROMISING Project: A Pilot Study to Improve Geriatric Care Through a Pharmacist-Led Psychotropic Stewardship Program</atitle><jtitle>Drugs & aging</jtitle><stitle>Drugs Aging</stitle><date>2023-11-01</date><risdate>2023</risdate><volume>40</volume><issue>11</issue><spage>1037</spage><epage>1045</epage><pages>1037-1045</pages><issn>1170-229X</issn><eissn>1179-1969</eissn><abstract>Background and objective
Psychotropic medications are frequently prescribed during acute care, even in older patients. They represent a risk for inappropriate long-term use and increase the overall risk of morbidity and mortality in this population. Our project aimed to evaluate the feasibility of a psychotropic medication stewardship program led by pharmacists.
Methods
We conducted a prospective, observational pilot study in patients aged 75 years and older, admitted to a surgical unit with at least one active prescription of a psychotropic medication (antipsychotic, benzodiazepine or non-benzodiazepine receptor agonist). Each psychotropic medication was assessed for potential deprescription, and if eligible, a recommendation from the stewardship pharmacist was made to the medical team.
Results
Among 183 patients, 93.4% were eligible for a potential deprescription. A total of 298 prescriptions were evaluated by the stewardship pharmacists, of which 57.7% were antipsychotics, 22.8% were benzodiazepines and 19.5% were non-benzodiazepine receptor agonists. Most of the assessed prescriptions were started during current hospitalization (62.7%). The median time required for the intervention per patient was 17 min 30 s. The stewardship pharmacists made 192 suggestions for 258 eligible prescriptions, with 69.8% being deprescription recommendations. Of all the deprescription suggestions, 75.4% were accepted by the medical team and 84.8% of those accepted persisted at discharge.
Conclusion
The implementation of a pharmacist-led psychotropic medication stewardship program on surgical units in our hospital is feasible and is a promising approach to improve geriatric care.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1007/s40266-023-01063-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3360-4831</orcidid><orcidid>https://orcid.org/0000-0002-8526-857X</orcidid></addata></record> |
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| ispartof | Drugs & aging, 2023-11, Vol.40 (11), p.1037-1045 |
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| subjects | Antibiotics Antipsychotics Benzodiazepines Clinical outcomes Drug stores Electronic health records Geriatrics Geriatrics/Gerontology Hospitalization Hospitals Internal Medicine Medicine Medicine & Public Health Mortality Older people Original Research Article Patients Pharmacology/Toxicology Pharmacotherapy Pilot projects Prescriptions Psychotropic drugs Variance analysis |
| title | The PROMISING Project: A Pilot Study to Improve Geriatric Care Through a Pharmacist-Led Psychotropic Stewardship Program |
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