title: Reduction in the use of potentially inappropriate drugs among old people living in geriatric care units between 2007 and 2013.
abstract: OBJECTIVE
  The aims of this study were to investigate trends in the prevalence of potentially inappropriate drug use among old people living in geriatric care units in the county of Västerbotten between 2007 and 2013 using six national quality indicators and to assess the impact of medication reviews on those quality indicators.
  
  
  METHODS
  Data were collected concerning potentially inappropriate drug use, function in the activities of daily living (ADL) and cognitive function, using the Multi-Dimensional Dementia Assessment Scale (MDDAS). A comparison was made between the years 2007 and 2013, comprising 2772 and 1902 people, respectively, living in geriatric care in the county of Västerbotten, Sweden. We conducted a parallel investigation of a separate corresponding population in Västerbotten County from 2012, where potentially inappropriate drug use was measured before and after 895 medication reviews which involved a clinical pharmacist.
  
  
  RESULTS
  After controlling for age, sex, ADL and cognitive impairment, there was a significant improvement in five out of six quality indicators between 2007 and 2013. While 44% of the people were exposed to one or more potentially inappropriate medications in 2007, this number had declined to 26% by 2013. In the separate population from 2012, the frequency of potentially inappropriate drug use was significantly reduced amongst the people who had a medication review performed.
  
  
  CONCLUSIONS
  The extent of potentially inappropriate drug use declined between 2007 and 2013 according to the quality indicators used. Medication reviews involving clinical pharmacists might be an important factor in reducing potentially inappropriate drug use and improving drug treatment among old people.
authors.affiliation: Department of Pharmacology and Clinical Neurosciences, Division of Clinical Pharmacology, Umeå University, 901 87, Umeå, Sweden, maria.gustafsson@umu.se.
authors.forename: Maria
authors.initials: M
authors.lastname: Gustafsson
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Sandman
authors.forename: Stig
authors.initials: S
authors.lastname: Karlsson
authors.forename: Ulf
authors.initials: U
authors.lastname: Isaksson
authors.forename: Jörn
authors.initials: J
authors.lastname: Schneede
authors.forename: Maria
authors.initials: M
authors.lastname: Sjölander
authors.forename: Hugo
authors.initials: H
authors.lastname: Lövheim
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D003704:Dementia / Q000503:physiopathology; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D000067561:Potentially Inappropriate Medication List / Q000706:statistics & numerical data / Q000639:trends*; D055553:Prescription Drugs / Q000008:administration & dosage* / Q000009:adverse effects; D015995:Prevalence; D013548:Sweden
chemical_list: D055553:Prescription Drugs