Using data to change drug utilization in the real world

Lisa G. Pont, Christine Veal, Andrew Flemming, Lee-Fay Low, Sonali Pinto

Research output: Contribution to journalMeeting abstractpeer-review

Abstract

Background: Using data to drive practice change is commonly used in the research world, yet using data to support change in the real-world presents unique challenges.
Objectives: The aim of this study was to design, develop and evaluate a data-driven evidence-based intervention for changing anti-psychotic use for behavioural and psychological symptoms of dementia (BPSD) in residential aged care.
Methods: A mixed methods approach was utilized. Qualitative data regarding attitudes to antipsychotics were collected via focus groups, and thematic analysis was used to identify local potential barriers and facilitators for change at each site. A suite of evidence-based multidisciplinary interventions was
implemented across 26 residential aged care facilities (1800 residents) commencing February 2014. Strategies were developed at the organizational, facility and individual health professional levels and included audit and feedback, education, support, skills training and policy changes. Administrative medication supply data were used to provide audit and feedback at the
facility level as well as to evaluate the program. Changes in the number of antipsychotic users were analyzed using Cochran’s Q and changes in the
number of defined daily doses (DDDs) analyzed using a linear mixed model.
Results: The median facility size was 45 beds, and 21 pharmacies supplied medications to the 26 facilities. The qualitative analysis identified a number of
challenges regarding the use of antipsychotics in aged care including lack of awareness regarding the risks of antipsychotics and poor confidence in managing resident behaviour without using antipsychotics. The total number of antipsychotic users decreased from 9.5% to 4.5% over the 6-month intervention
period (p=0.000). For dosing, the total number of DDDs decreased from 0.342 to 0.194 (p =0.000) over the same period.
Conclusions: Antipsychotic use for BPSD decreased significantly following implementation of a data-driven evidence-based approach. Using data to understand the barriers to change and individualize interventions to support local needs based on local site needs allows complex interventions to be conducted to improve quality use of medicines and drug utilization in the real world.
Original languageEnglish
Article number59
Pages (from-to)35
Number of pages1
JournalPharmacoepidemiology and Drug Safety
Volume24
Issue numberS1
Publication statusPublished - Sep 2015

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