Interventions to prevent drug related death and harm amongst elderly

Key message

Background

A national patient safety campaign, planned to start in 2011, is being prepared. To support decisions regarding interventions, we have performed a rapid summary of evidence supporting interventions to prevent drug related death and harm amongst elderly. Pre-stated interventions were medication reconciliation, education, interventions for handling of drugs that pose special risks, electronic ordination and control systems for transfer and discharge, including dose dispensing systems.

Commission

The summary was performed on commission of The Norwegian Knowledge Centre for the Health Services, The secretary of the patient safety campaign 2011. 

Main conclusions (graded body of evidence)

• Multifactorial interventions like medication reconciliation, education and patient follow up may reduce inappropriate use of drugs (very low to low quality). 
• There is insufficient evidence to judge if any single intervention, or a multifactorial intervention, may lead to reduced medication associated mortality, less medication associated harm or improved quality of life.
• There is insufficient evidence to judge if electronic ordination, or any particular control system for transfer or discharge on its own may influence the use of drugs.

The conclusions were made based on results in a Swedish HTA report and a recently published report from The Norwegian Knowledge Centre. A rapid review of abstracts of 28 systematic reviews and reports published after 2005 gave support to the conclusions.