Researchers tested a simulation to train doctors on prescribing high-risk medications to hospitalized older adults despite recommendations to avoid the drugs. The intervention didn’t affect high-risk prescribing, but it did result in the medical residents prescribing fewer drugs to be taken on an as-needed basis.
Simulations are being used more often to train healthcare professionals to handle stressful situations in the moment, the team wrote in the study published March 8 in the Journal of the American Geriatrics Society.
High-risk medications include benzodiazepines, sedative hypnotics and antipsychotics.
The team put 40 first-year medical residents, or interns, into random groups. One group got a 40-minute simulation training and the other received online education training. The researchers wanted to see differences in prescribing after the people learned about prescribing the medications in older people.The researchers also wanted to see if patients were discharged and still on one of the medications and evaluate orders for related or control drugs. A total of 522 patients were included in the analysis.
The researchers used electronic health record data during the course of the study span, which took about two weeks.
Overall, 4.9% of the residents in the simulation training group prescribed one or more high-risk drugs for patients, while 5% of residents in the control training did the same. In other words, the intervention didn’t change the number of new prescriptions.
In a second analysis, however, researchers noted that the residents prescribed fewer drugs to be taken as needed. The simulation training residents wrote more one-time orders compared to residents in the control group, data showed.
“Despite our prior interviews suggesting a need to address high-risk prescribing and an interest in using simulation to address these gaps, a single training session may not have been sufficient on its own to suppress high-risk prescribing,” the authors wrote.
