Journal of General Internal Medicine

, Volume 6, Issue 2, pp 133–136

Reduction of polypharmacy by feedback to clinicians

  • Thomas J. Meyer
  • David Van Kooten
  • Shawn Marsh
  • Allan V. Prochazka
Original Articles

DOI: 10.1007/BF02598309

Cite this article as:
Meyer, T.J., Van Kooten, D., Marsh, S. et al. J Gen Intern Med (1991) 6: 133. doi:10.1007/BF02598309

Abstract

Objective:To determine whether two different educational interventions would reduce polypharmacy in outpatients receiving ten (10) or more active medications at the Denver Veterans Affairs Center.

Design:292 patients were randomized into three (3) groups: Control (n=88); simple notification of primary care provider (n=102); intensive notification, provision of pharmacy profiles, compliance index, and chart review by senior clinician with recommendations (n=104).

Setting:Veterans Affairs Medical Center affiliated with the University of Colorado Health Sciences Center.

Patients/Participants:All patients receiving greater than ten (10) active medications who are followed by clinic staff at the Denver VAMC. The mean age was 62 years (range 26–88) and 96% were male.

Interventions:The simple notification group received only a single letter recommending that the patient’s number of medications be reduced. The intensive notification group received more sophisticated intervention with a chart review, two letters with calculation of patient compliance, and individualized suggestions for reduction in polypharmacy. The control group received no intervention.

Measurements and main results:Control patients had significantly less reduction in polypharmacy then either the simple or intensive intervention groups at four months (p=0.028). There was no significant difference between the intervention groups (p=0.189). By six months the difference was no longer significant.

Conclusions:A simple intervention can result in a significant reduction in the number of medications prescribed to patients with polypharmacy. The authors were unable to show that a more complex intervention resulted in a further reduction in polypharmacy.

Key words

polypharmacydrugsmedicationsutilizationinterventionsphysician behavior

Copyright information

© Glaxo Inc. 1987

Authors and Affiliations

  • Thomas J. Meyer
    • 1
  • David Van Kooten
    • 1
  • Shawn Marsh
    • 1
  • Allan V. Prochazka
    • 1
  1. 1.Denver VAMCDenver