Aaron M. Gilson , Jamie A. Stone , Maria E. Berbakov , Emily L. Hoffins , Joel Gollhardt , Kenneth Walker , Michelle A. Chui
{"title":"评估一种新的基于药物的干预措施的持续有效性,以减少老年人对非处方药的滥用:一个无意义的案例。","authors":"Aaron M. Gilson , Jamie A. Stone , Maria E. Berbakov , Emily L. Hoffins , Joel Gollhardt , Kenneth Walker , Michelle A. Chui","doi":"10.1016/j.sapharm.2025.01.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Misuse of over-the-counter (OTC) medications by older adults (age 65+) can comprise Drug-Age, Drug-Drug, Drug-Disease, and Drug-Label types. Pharmacies in the United States are prevalent sources of OTCs and are an apt setting to address OTC misuse. Senior Safe™ is a pharmacy-system redesign for preventing older adult OTC misuse. The redesign uses signage to designate high-risk OTCs and safer products for older adult use, as well as prompting older adults to engage with pharmacy staff around medication safety issue.</div></div><div><h3>Objectives</h3><div>This study compared misuse in pharmacies with initial Senior Safe implementation (Immediate Effects group) to pharmacies with Senior Safe after 3 months (Sustained Effects group).</div></div><div><h3>Methods</h3><div>A non-equivalent group design, involving older adults recruited from matched and randomly-allocated pharmacy sites within a health system, compared the Immediate Effects (n = 83) and Sustained Effects (n = 65) groups. All participants were recruited outside the pharmacy and were given hypothetical symptom scenarios from which to choose (i.e., cough/cold/allergy, pain, or sleep). Participants were then asked to select an OTC to treat that symptom, and explain their OTC use at symptom onset and if symptoms persisted/worsened. Participants’ reported OTC use was evaluated for each misuse type. Multivariate modeling estimated differences in misuse between the Immediate and Sustained Effects groups.</div></div><div><h3>Results</h3><div>No significant differences emerged between Immediate and Sustained Effect groups for any misuse type for which statistical modeling was conducted. Drug-Age misuse was statistically less likely for sleep products (OR = 0.170, p = .005) and for adults aged 85+ when compared to the 65–74 and 75–84 age categories (OR = 3.979, p = .053; OR = 6.900, p = .031, respectively).</div></div><div><h3>Conclusions</h3><div>These non-significant results suggest that the intervention effect was maintained at three months. Overall, then, misuse reductions occurring immediately after intervention implementation did not significantly increase after three months. System buy-in, including assessing costs to implement and maintain Senior Safe, is critical to promote broader adoption.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"21 4","pages":"Pages 253-261"},"PeriodicalIF":3.7000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating the sustained effectiveness of a novel pharmacy-based intervention to reduce older adult misuse of over-the-counter medications: A case for non-significance\",\"authors\":\"Aaron M. Gilson , Jamie A. Stone , Maria E. Berbakov , Emily L. Hoffins , Joel Gollhardt , Kenneth Walker , Michelle A. Chui\",\"doi\":\"10.1016/j.sapharm.2025.01.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Misuse of over-the-counter (OTC) medications by older adults (age 65+) can comprise Drug-Age, Drug-Drug, Drug-Disease, and Drug-Label types. Pharmacies in the United States are prevalent sources of OTCs and are an apt setting to address OTC misuse. Senior Safe™ is a pharmacy-system redesign for preventing older adult OTC misuse. The redesign uses signage to designate high-risk OTCs and safer products for older adult use, as well as prompting older adults to engage with pharmacy staff around medication safety issue.</div></div><div><h3>Objectives</h3><div>This study compared misuse in pharmacies with initial Senior Safe implementation (Immediate Effects group) to pharmacies with Senior Safe after 3 months (Sustained Effects group).</div></div><div><h3>Methods</h3><div>A non-equivalent group design, involving older adults recruited from matched and randomly-allocated pharmacy sites within a health system, compared the Immediate Effects (n = 83) and Sustained Effects (n = 65) groups. All participants were recruited outside the pharmacy and were given hypothetical symptom scenarios from which to choose (i.e., cough/cold/allergy, pain, or sleep). Participants were then asked to select an OTC to treat that symptom, and explain their OTC use at symptom onset and if symptoms persisted/worsened. Participants’ reported OTC use was evaluated for each misuse type. Multivariate modeling estimated differences in misuse between the Immediate and Sustained Effects groups.</div></div><div><h3>Results</h3><div>No significant differences emerged between Immediate and Sustained Effect groups for any misuse type for which statistical modeling was conducted. Drug-Age misuse was statistically less likely for sleep products (OR = 0.170, p = .005) and for adults aged 85+ when compared to the 65–74 and 75–84 age categories (OR = 3.979, p = .053; OR = 6.900, p = .031, respectively).</div></div><div><h3>Conclusions</h3><div>These non-significant results suggest that the intervention effect was maintained at three months. Overall, then, misuse reductions occurring immediately after intervention implementation did not significantly increase after three months. 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引用次数: 0
摘要
老年人(65岁以上)滥用非处方(OTC)药物可包括药物年龄、药物-药物、药物-疾病和药物标签类型。美国的药店是OTC的普遍来源,是解决OTC滥用的合适场所。Senior Safe™是一个重新设计的药物系统,用于防止老年人滥用OTC。重新设计使用标识来指定高风险的otc和老年人使用的更安全的产品,并促使老年人就药物安全问题与药房工作人员进行接触。目的:本研究比较了最初实施Senior Safe的药店(即时效果组)和3个月后实施Senior Safe的药店(持续效果组)的滥用情况。方法:采用非等效组设计,从卫生系统内匹配和随机分配的药房招募老年人,比较即时效果组(n = 83)和持续效果组(n = 65)。所有参与者都是在药店外招募的,并给出了可供选择的假设症状场景(即咳嗽/感冒/过敏、疼痛或睡眠)。然后,参与者被要求选择一种非处方药来治疗该症状,并解释他们在症状出现时的非处方药使用情况,以及症状是否持续/恶化。评估参与者报告的每种滥用类型的OTC使用情况。多变量模型估计了即时效果组和持续效果组之间滥用药物的差异。结果:即时效应组和持续效应组在任何误用类型上均无显著差异。与65-74岁和75-84岁年龄组相比,睡眠产品和85岁以上成年人滥用药物的可能性在统计学上更低(OR = 0.170, p = 0.005) (OR = 3.979, p = 0.053;OR = 6.900, p = 0.031)。结论:这些无显著性结果表明干预效果在3个月时保持。总的来说,干预实施后立即发生的滥用减少在三个月后没有显著增加。系统支持,包括评估实施和维护Senior Safe的成本,对于促进更广泛的采用至关重要。
Evaluating the sustained effectiveness of a novel pharmacy-based intervention to reduce older adult misuse of over-the-counter medications: A case for non-significance
Introduction
Misuse of over-the-counter (OTC) medications by older adults (age 65+) can comprise Drug-Age, Drug-Drug, Drug-Disease, and Drug-Label types. Pharmacies in the United States are prevalent sources of OTCs and are an apt setting to address OTC misuse. Senior Safe™ is a pharmacy-system redesign for preventing older adult OTC misuse. The redesign uses signage to designate high-risk OTCs and safer products for older adult use, as well as prompting older adults to engage with pharmacy staff around medication safety issue.
Objectives
This study compared misuse in pharmacies with initial Senior Safe implementation (Immediate Effects group) to pharmacies with Senior Safe after 3 months (Sustained Effects group).
Methods
A non-equivalent group design, involving older adults recruited from matched and randomly-allocated pharmacy sites within a health system, compared the Immediate Effects (n = 83) and Sustained Effects (n = 65) groups. All participants were recruited outside the pharmacy and were given hypothetical symptom scenarios from which to choose (i.e., cough/cold/allergy, pain, or sleep). Participants were then asked to select an OTC to treat that symptom, and explain their OTC use at symptom onset and if symptoms persisted/worsened. Participants’ reported OTC use was evaluated for each misuse type. Multivariate modeling estimated differences in misuse between the Immediate and Sustained Effects groups.
Results
No significant differences emerged between Immediate and Sustained Effect groups for any misuse type for which statistical modeling was conducted. Drug-Age misuse was statistically less likely for sleep products (OR = 0.170, p = .005) and for adults aged 85+ when compared to the 65–74 and 75–84 age categories (OR = 3.979, p = .053; OR = 6.900, p = .031, respectively).
Conclusions
These non-significant results suggest that the intervention effect was maintained at three months. Overall, then, misuse reductions occurring immediately after intervention implementation did not significantly increase after three months. System buy-in, including assessing costs to implement and maintain Senior Safe, is critical to promote broader adoption.
期刊介绍:
Research in Social and Administrative Pharmacy (RSAP) is a quarterly publication featuring original scientific reports and comprehensive review articles in the social and administrative pharmaceutical sciences. Topics of interest include outcomes evaluation of products, programs, or services; pharmacoepidemiology; medication adherence; direct-to-consumer advertising of prescription medications; disease state management; health systems reform; drug marketing; medication distribution systems such as e-prescribing; web-based pharmaceutical/medical services; drug commerce and re-importation; and health professions workforce issues.