title: Impact of an Innovative Educational Strategy on Medication Appropriate Use and Length of Stay in Elderly Patients.
abstract: To evaluate the impact of an educational strategy on potentially inappropriate medications (PIMs) and length of stay in hospitalized elderly patients.
  
  
  METHODS
  An open study, with two cross-sectional surveys interspersed with an educational program (PRE phase and POST phase), has been performed in order to compare the PIMs number before and after the introduction of an educational strategy. The study included 2 phases: PRE, in which patients were enrolled as control group; POST, in which an educational strategy on the PIMs use was introduced among physicians, and patients were enrolled as intervention group.
  
  
  METHODS
  Italian residential rehabilitation Centre. Inclusion criteria were ≥ 2 active chronic diseases and the current use of ≥ 4 medications. The educational strategy consisted of a 3-day course on strategies to prevent PIMs and a computerized tool running on a Personal Digital Assistant (PDA) device to check for PIMs.
  
  
  RESULTS
  The primary was the PIMs number, the secondary the length of stay.
  
  
  RESULTS
  A total of 790 patients, 450 controls and 340 cases, were enrolled. According to the Beers criteria, 52.3% of the study population received ≥ 1 PIMs, 18.73% ≥ 2, and 2.4% ≥ 4 PIMs. A significant reduction of PIMs (P = 0.020) and length of stay (P < 0.0001) were seen in the intervention group. At multivariate analysis, PIMs significantly correlated with age, drugs number, and the intervention, and the length of stay significantly correlated with disease count, comorbidities, and intervention. These data suggest that our educative instrument may be useful in reducing the PIMs number and length of hospitalization in elderly with a high number of drugs and comorbidities.
authors.affiliation: From Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy (GC, GP); Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy (GG, RB); Division of Brain Sciences, Imperial College London, UK (GP); Department of Medicine and Surgery, University of Salerno, Baronissi (SA), Italy (GR, VC, AF); Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy (GR, DL, NF); and Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese, Telese Terme (BN), Italy (GR, NF).
authors.forename: Graziamaria
authors.initials: G
authors.lastname: Corbi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gambassi
authors.forename: Gennaro
authors.initials: G
authors.lastname: Pagano
authors.forename: Giusy
authors.initials: G
authors.lastname: Russomanno
authors.forename: Valeria
authors.initials: V
authors.lastname: Conti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rengo
authors.forename: Dario
authors.initials: D
authors.lastname: Leosco
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.forename: Amelia
authors.initials: A
authors.lastname: Filippelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferrara
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control* / Q000706:statistics & numerical data; D007318:Inservice Training / Q000458:organization & administration*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010820:Physicians / Q000706:statistics & numerical data*; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D012737:Sex Factors