Alternatives for potentially inappropriate medications in the elderly population: treatment algorithms for use in the Fleetwood Phase III Study.
OBJECTIVE
To provide estimates of the prevalence of potentially inappropriate medications used in eligible nursing facilities, to describe the development of evidence-based treatment algorithms for recommending safer alternative treatments to potentially inappropriate medications, and to provide the actual treatment algorithms developed for the Fleetwood Phase III study.


METHODS
Literature review, cross-sectional design.


METHODS
Thirty North Carolina nursing facilities eligible for Fleetwood Phase III.


METHODS
Algorithms developed for use by all pharmacists in the long-term care pharmacy serving the intervention facilities site for the Fleetwood Phase III study.


METHODS
Pharmacists are prospectively intervening directly with the prescriber to recommend a safer alternative to inappropriate medications using the standardized treatment algorithms developed for the study.


METHODS
Prevalence of potentially inappropriate medications used among residents and the development of 14 treatment algorithms suggesting appropriate alternatives to inappropriate medications.


RESULTS
The percentage of potentially inappropriate medications used ranged from 0% to 13.2% at baseline in March 2002. We also found that evidence-based treatment algorithms were well received by consultant pharmacists at the intervention sites of the Fleetwood Phase III study.


CONCLUSIONS
We have provided prevalence rates of potentially inappropriate medication use in nursing homes and developed treatment algorithms for pharmacists to use when making clinical recommendations regarding safer alternatives to potentially inappropriate medications in the elderly population. We are in the process of evaluating the effect of pharmacists' prospective interventions by using these standardized evidence-based treatment algorithms to reduce the prevalence of inappropriate medication use in intervention facilities.
Department of Community Health, Brown University, Providence, RI 02912, USA. Jennifer_Christian@brown.edu
Jennifer B
JB
Christian
Anne
A
Vanhaaren
Kathleen A
KA
Cameron
Kate L
KL
Lapane