Table 1 Description of included primary studies for the comparison educational outreach versus usual practice
Study | Participants | Intervention | Comparison | Outcomes |
|---|---|---|---|---|
Avorn 1992 [10] | Physicians, nurses and nursing assistants in 6 nursing homes with 431 residents in the experiment group and 6 nursing homes with 392 residents in the control group in the US. Age: Not reported. | Aimed to reduce the excessive use of sedating drugs. Three interactive educational outreach visits by a pharmacist to nursing home physicians to reduce the use of psychoactive drugs. Only physicians that exceeded a treshold value for psychoactive drug prescribing at the baseline evaluation were targeted. Six literature summaries done by research team on e.g. management of insomnia, confusion and agitation were disseminated to all physicians in three mailings and used as discussion aids in the educational visit. Four training sessions were held for nurses and nursing assistants in separate groups on patient care, alternatives to psychoactive drugs and adverse effects. Extent of implementation: Not reported. | Usual care. | Score for use of psychoactive drugs, proportion of residents using antipsychotics. |
Crotty 2004a [13] | 61 physicians, nurses and nursing assistants in 10 nursing homes with 381 residents in the experiment group and 37 physicians with other health personnel in 10 nursing homes with 334 residents in the control group. Mean age: 84 years. | Aimed at implementing evidence based practice in residential care. Doctors received two 30 minute educational outreach visits by a pharmacist in their offices. The risks of psychotropic drug use was one of several other key messages, combined with detailed audit information on fall rates, psychotropic prescribing patterns and stroke risk reduction practices in the nursing home of each physician. A link nurse was appointed at each facility. The link nurses were trained in four two hour sessions in which medication management was one of the topics. Also, a pharmacist visited each nursing home and spoke to staff about reducing the use of psychotropic medication. Extent of implementation: Not reported. | Usual care | Percentage of residents prescribed and administered any psychotropic medication, percentage of residents who had a fall incident in a 3 month period. |