Table 4.
Outcomes describing potentially inappropriate medicine use at baseline and after 12 months in the per protocol intervention group and control groups and significance of changes within and between the groups during the follow-up
| Medication in use | Intervention group (N = 27) | Control group (N = 64) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Baseline | At 12 months | Adjusted mean change [95% CI] or adjusted OR (95% CI) for change | p for change | Baseline | At 12 months | Adjusted mean change [95% CI] or adjusted OR (95% CI) for change | p for change | Pi for the difference in change between the groups | |
| Number of all medications, mean (SD) | 14.0 (3.9) | 13.3 (3.3) | −0.02 [−1.24–1.20] | 0.97 | 12.7 (4.3) | 13.0 (4.0) | 0.38 [−0.59–1.36] | 0.44 | 0.46 |
| Harmful medicationa user, n (%) | 23 (85.2) | 22 (81.5) | 0.61 (0.13–2.88) | 0.54 | 51 (79.7) | 51 (79.7) | 1.00 (0.50–2.02) | 1.00 | 0.58 |
| Beers Criteria [23] medication user, n (%) | 26 (96.3) | 25 (92.6) | 0.42 (0.02–7.52) | 0.56 | 58 (90.6) | 57 (89.1) | 0.82 (0.34–1.95) | 0.65 | 0.67 |
| Psychotropic medicationb user, n (%) | 21 (77.8) | 19 (70.4) | 0.47 (0.04–5.24) | 0.54 | 32 (50.0) | 30 (46.9) | 0.56 (0.11–2.72) | 0.47 | 0.90 |
| Anticholinergic medicationc user, n (%) | 8 (29.6) | 5 (18.5) | 0.62 (0.25–1.56) | 0.31 | 12 (18.8) | 12 (18.8) | 1.00 (0.72–1.39) | 1.00 | 0.34 |
| CNS medicationd user, n (%) | 25 (92.6) | 20 (74.1) | 0.15 (0.03–0.80) | 0.03 | 45 (70.3) | 43 (67.2) | 0.81 (0.37–1.77) | 0.59 | 0.08 |
| Therapeutic duplication | |||||||||
| Proportion using > 3 psychotropic medicationsb, n (%) | 5 (18.5) | 2 (7.4) | 0.35 (0.11–1.10) | 0.07 | 6 (9.4) | 5 (7.8) | 0.82 (0.42–1.62) | 0.56 | 0.21 |
| Proportion using > 2 serotonergic medications [27], n (%) | 6 (22.2) | 7 (26.0) | 1.28 (0.56–2.92) | 0.56 | 5 (7.8) | 7 (10.9) | 1.49 (0.68–3.26) | 0.32 | 0.79 |
| Use of special ATC classes | |||||||||
| Antipsychotics userse, n (%) | 6 (22.2) | 4 (14.8) | 0.59 (0.20–1.69) | 0.32 | 7 (10.9) | 7 (10.9) | 1.00 (0.61–1.65) | 1.00 | 0.37 |
| BZDf users, n (%) | 15 (55.6) | 10 (37.0) | 0.43 (0.21–0.91) | 0.03 | 21 (32.8) | 20 (31.3) | 0.89 (0.47–1.67) | 0.71 | 0.15 |
| Opioidg users, n (%) | 11 (40.7) | 7 (26.0) | 0.49 (0.21–1.11) | 0.09 | 22 (34.4) | 20 (31.3) | 0.86 (0.57–1.30) | 0.47 | 0.23 |
| PPI (ATC A02BC) user, n (%) | 13 (48.2) | 13 (48.2) | 1.00 (0.62–1.61) | 1.00 | 30 (46.9) | 33 (51.6) | 1.23 (0.91–1.66) | 0.18 | 0.47 |
| Drug-drug interactions (DDI) | |||||||||
| Clinically significant DDI (class D) [24], n (%) | 2 (7.4) | 2 (7.4) | 1.00 (0.21–4.67) | 1.00 | 1 (1.6) | 0 (0.0) | NA | 0.32h | NA |
SD standard deviation, OR Odds ratio, CI Confidence interval, CNS central nervous system, BZD benzodiazepine, PPI proton-pump inhibitor, NA not available
a Harmful medications Included 1) Beers Criteria medications [23], 2) b psychotropic medications [26] (Included fBZDs and related drugs: ATC codes N05BA, N05CD, N03AE01, N05CF, A03CA, C01DA70, M05AA51, N06CA01, N02BA71; Antidepressants: ATC codes N06A, N06CA; eAntipsychotics: ATC codes N05A, N06CA01); 3) c Anticholinergic medications [26]: ATC codes: N04A, N05AA01, N05AA02, N05AB01, N05AB02, N05AB03, N05AB04, N05 AC01, N05 AC02, N05AF01, N05AF03, N05AF05, N05BB01, N06AA04, N06AA06, N06AA09, N06AA12, N02AG, A03AA, A03AB, A03AX03, A03B, A03CA, A03CB31, A03DA, A03FA01, A04AD01, A04AD12, C01BA01, C01BA03, C01BA51, C01BA71, R03BB, M03B, G04BD, S01FA, R01BA01, R01BA51, R06AB01, R06AE03, R06AE53). If the medication appeared in two or more criteria, they were considered only once
d CNS medications: gOpioids (ATC codes N01AH, N02A, N02BE51, R05DA, R05FA), canticholinergics [26]; antiepileptics (ATC N03A); fBZDs and related drugs (ATC codes N05BA, N05CD, N03AE01, N05CF, A03CA, C01DA70, M05AA51, N06CA01, N02BA71); Antidepressants (ATC codes N06A, N06CA); eAntipsychotics (ATC codes N05A, N06CA01). hMcNemar test due to zero frequencies. iAdjusted for functional ability Rava, CNS medications, GDS-15, MNA