Jf. Reeve et al., Programme to improve the use of drugs in older people and involve general practitioners in community education, J CLIN PH T, 24(4), 1999, pp. 289-297
As part of a multi-pronged approach to improving the quality of drug use in
the elderly, a pharmacist was contracted by the Division of General Practi
ce (Northern Tasmania) to develop educational material and implement two ac
ademic detailing sessions for general practitioners on the issues of advers
e drug reactions and drug interactions in older people. The project aimed t
o involve general practitioners in community education after optimizing rel
evant therapeutic knowledge and standardizing prescribing practices. Sixtee
n general practitioners were involved in the project and 13 of these agreed
to participate in academic detailing. The pharmacist developed prescribing
guidelines for general practitioners and discussed these and illustrative
case studies at the academic detailing sessions. General practitioner-condu
cted education sessions were completed by nine general practitioners to gro
ups of carers, general practitioners, nurses and older people. Despite the
relatively low numbers of general practitioners involved, the results of th
e project were encouraging. Academic detailing by the pharmacist was well r
eceived by the general practitioners, who indicated they would be willing t
o participate in further sessions. Pre- and post-project multiple-choice te
sts on therapeutic issues in the elderly indicated a strong trend for an in
crease in knowledge. Analysis of general practitioners' patient records fou
nd a statistically significant decline in the median numb er of medications
prescribed per patient during the project. There was also a statistically
significant decline in prescribing of 'indicator' medications, particularly
psychoactive drugs and nonsteroidal antiinflammatory drugs in patients res
ident in nursing homes. The project demonstrated that academic detailing by
a pharmacist can be effective as part of a combined approach to improve th
e quality of drug use in older people.