Skip to main content

Table 3 Impact of interventions to reduce use

From: Bridging evidence-practice gaps: improving use of medicines in elderly Australian veterans

Intervention number and topic (number of veterans targeted) Targeted therapy Proportion of veterans on targeted therapy at baseline (%) 24 month pre-intervention trend Intervention effect (%) 20 month post intervention trend Estimated number with changed behaviour as a result of intervention; sustained over two years post intervention
4: Clinical risk management: NSAIDs (n = 9885) Reduce NSAID use in those with heart failure 15.6% Trend decreasing − 0.8% per month −11.4% (p < 0.0001) Trend still decreasing (non-significant to prior) − 0.7% per month (p = 0.87) 1163 (680 heart failure patients and 483 diabetes patients)
Reduce NSAID use in those with diabetes 17.9% Trend decreasing − 1.2% per month −10.2% (p < 0.0001) Trend still decreasing but reduced to − 0.3% per month p = 0.006
5: Antidepressants: three steps towards safer use (n = 42196) Reduce antidepressant duplication 3.5% Trend increasing 0.2% per month 0.6% p = 0.72 Trend increasing at a rate of 0.5% per month p = 0.05 No effect
Reduce antidepressants with tramadol 5.8% Trend decreasing − 0.6% per month −1.0% p = 0.64 Trend still decreasing (non-significant to prior) − 0.8% per month p = 0.23
6: Inhaled respiratory medicines: optimising use (n = 28670) Reduce multiple device use (3 different devices) 9.5% Trend increasing 0.2% per month −0.11% p = 0.32 Trend now decreasing (non-significant to prior) − 0.2% per month p = 0.23 100 patients no longer on 4 or more different devices
Reduce multiple device use (4 or more different devices) 2% Trend increasing 0.1% per month 2% p = 0.60 Trend now decreasing − 0.6% per month p = 0.01
7: PPIs in GORD: Reduce the dose – keep the benefits (n = 62460) Reduce use of high dose proton pump inhibitors (measured as increase in low-dose use) 2.5% Trend of low dose increasing 0.6% per month 14.5% (p < 0.0001) Increase in low dose use Trend of low dose increasing at greater rate 0.9% per month (p = 0.007) 780
8: Reducing adverse drug events for your veteran patients (n = 32484) Reduce use of potentially inappropriate medicines 14.7% Trend decreasing − 0.2% per month −0.3% p = 0.12 Trend still decreasing (non-significant to prior) − 0.2% per month p = 0.63 No effect
12: Antipsychotics in dementia (n = 6690) Reduce antipsychotic use 0.54% Trend increasing 3.6% per month −14.3% (p < 0.0001) Trend increasing but at a reduced rate 0.8% per month (p < 0.0001) 1725
14: COPD (n = 18096) Reduce multiple device use (4 or more different devices) 2% Trend increasing 0.1% per month 2% p = 0.68 Trend now decreasing − 1.1% per month p <0.0001 105 patients no longer on 4 or more different devices
Reduce use of nebules 15.2% Trend decreasing − 0.6% per month 2% p = 0.07 Trend decreasing (non-significant to prior) − 0.8% per month p = 0.2
  1. NSAID, non-steroidal anti-inflammatory drug; PPI, proton pump inhibitor; GORD, gastro-oesophageal reflux disease; COPD, chronic obstructive pulmonary disease.