@article{ref1,
title="Nursing Home PRevention of Injury in DEmentia (NH PRIDE): a pilot study of a remote injury prevention service for NH residents",
journal="Journal of the American Geriatrics Society",
year="2023",
author="Berry, Sarah D. and Hecker, Emily J. and McConnell, Eleanor S. and Xue, Tingzhong-Michelle and Tsai, Timothy and Zullo, Andrew R. and Colón-Emeric, Cathleen",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Medication optimization, including prescription of osteoporosis medications and deprescribing medications associated with falls, may reduce injurious falls. Our objective was to describe a remote, injury prevention service (NH PRIDE) designed to optimize medication use in nursing homes (NHs), and to describe its implementation outcomes in a pilot study. <br><br>METHODS: This was a non-randomized trial (pilot study) including NH staff and residents from five facilities. Long-stay residents at high-risk for injurious falls were identified using a validated risk calculator and staff referral. A remote team reviewed the electronic health record (EHR) and provided recommendations as Injury Prevention Plans (IPP). A research nurse served as a care coordinator focused on resident engagement and shared decision-making. Outcomes included implementation measures, as identified in the EHR, and surveys and interviews with staff. <br><br>RESULTS: Across five facilities, 274 residents were screened for eligibility, and 46 residents (16.8%) were enrolled. Most residents were female (73.9%) and had dementia (63.0%). An IPP was completed for 45 residents (97.8%). The nurse made a total of 93 deprescribing recommendations in 36 residents (80% of residents had one or more deprescribing recommendation; mean 2.2 recommendations/resident). Twenty of 45 residents (44.4%) had a recommendation for osteoporosis treatment. Among residents with recommendations, 21/36 (58.3%) had one or more deprescribing orders written and 6/20 (30.0%) had an osteoporosis medication prescribed. At 4 months, most medication changes persisted. Adverse side effects were rare. Staff members identified several areas for program refinement, including aligning recommendations with provider workflow and engaging consultant psychiatrists. <br><br>CONCLUSIONS: A remote injury prevention service is safe and feasible to enhance deprescribing and osteoporosis treatment in long-stay NH residents at risk for injury. Additional investigation is needed to determine if this model could reduce injurious falls when deployed across NH chains.<p /> <p>Language: en</p>",
language="en",
issn="0002-8614",
doi="10.1111/jgs.18564",
url="http://dx.doi.org/10.1111/jgs.18564"
}