@article{ref1,
title="Nurse education to reduce harmful medication use in assisted living facilities: effects of a randomized controlled trial on falls and cognition",
journal="Drugs and aging",
year="2015",
author="Juola, Anna-Liisa and Bjorkman, Mikko P. and Pylkkanen, Sarita and Finne-Soveri, Harriet and Soini, Helena and Kautiainen, Hannu and Simon Bell, J. and Pitkälä, Kaisu H.",
volume="32",
number="11",
pages="947-955",
abstract="BACKGROUND: Psychotropic and anticholinergic medications may increase the risk of falls and impair cognition. <br><br>OBJECTIVE: The aim of the study was to investigate whether educating nursing staff in assisted living facilities about harmful medication use has effects on the incidence of falls and cognition. <br><br>METHODS: This was a secondary analysis of a cluster randomized controlled trial (N = 227 residents, ≥65 years) in 20 wards in assisted living facilities in Helsinki, Finland. Wards were randomized to those in which staff received two 4-h interactive training sessions to recognize potentially harmful medications (intervention group) and a control group. Cognition (verbal fluency, clock-drawing test) was assessed at baseline and 6 and 12 months. The number of falls per resident over the 12-month follow-up was recorded. <br><br>RESULTS: The prevalence of harmful medication use declined in the intervention group {-11.7 % [95 % confidence interval (CI) -20.5 to -2.9]; p = 0.009}, but remained constant in the control group [+3.4 % (95 % CI -3.7 to 10.6); p = 0.34]. There were 171 falls in the intervention group (2.25 falls/person year, 95 % CI 1.93-2.62) and 259 falls in the control group (3.25 falls/person year, 95 % CI 2.87-3.67) [incidence rate ratio 0.72 (95 % CI 0.59-0.88); p < 0.001]. Residents in the intervention group with a Mini-Mental State Examination (MMSE) score ≥10 had significantly less falls compared with respective residents in the control group (p < 0.001). Changes in verbal fluency or clock drawing test were not significantly different between the groups. <br><br>CONCLUSION: Educating nurses using activating learning methods can reduce the prevalence of harmful medications and the incidence of falls among residents in institutional settings.<p /> <p>Language: en</p>",
language="en",
issn="1170-229X",
doi="10.1007/s40266-015-0311-8",
url="http://dx.doi.org/10.1007/s40266-015-0311-8"
}