Evidence map›Paper›PMID 26446153›Full record

Trial reportDrugs & aging2015

Nurse Education to Reduce Harmful Medication Use in Assisted Living Facilities: Effects of a Randomized Controlled Trial on Falls and Cognition.

Anna-Liisa Juola, Mikko P Bjorkman, Sarita Pylkkanen, Harriet Finne-Soveri, Helena Soini, Hannu Kautiainen, J Simon Bell, Kaisu H Pitkala

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Drugs & aging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 10 pooled it
3.6field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 10 syntheses or guidelines pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Interventions for preventing falls in older people in care facilities.The Cochrane database of systematic reviews · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Anna-Liisa JuolaCity of Porvoo, Health Sevices, PO Box 23, 06101, Porvoo, Finland. anna-liisa.juola@fimnet.fi.ORCID http://orcid.org/0000-0002-0081-929X
Mikko P BjorkmanDepartment of General Practice, University of Helsinki, PO Box 20, 00014, University of Helsinki, Finland. mikko.bjorkman@helsinki.fi.
Sarita PylkkanenDivision of Social Pharmacy, Faculty of Pharmacy, University of Helsinki, PO Box 56, 00014, University of Helsinki, Finland. sarita.pylkkanen@carea.fi.
Harriet Finne-SoveriNational Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland. harriet.finne-soveri@thl.fi.
Helena SoiniSocial Services and Health Care Department, 4 A, PO Box 8555, 00099, City of Helsinki, Finland. helena.soini@hel.fi.
Hannu KautiainenDepartment of General Practice, University of Helsinki, PO Box 20, 00014, University of Helsinki, Finland. hannu.kautiainen@medcare.fi.
J Simon BellFaculty of Pharmacy and Pharmaceutical Sciences, Centre for Medicine Use and Safety, Monash University, Melbourne, Australia. Simon.Bell@unisa.edu.au.
Kaisu H PitkalaDepartment of General Practice, University of Helsinki, PO Box 20, 00014, University of Helsinki, Finland. kaisu.pitkala@helsinki.fi.
University of Helsinki · FIDepartment of Social Services · AUFinnish Institute for Health and Welfare · FIUniversity of South Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPsychotropic and anticholinergic medications may increase the risk of falls and impair cognition.

objectiveThe aim of the study was to investigate whether educating nursing staff in assisted living facilities about harmful medication use has effects on the incidence of falls and cognition.

methodsThis was a secondary analysis of a cluster randomized controlled trial (N = 227 residents, ≥65 years) in 20 wards in assisted living facilities in Helsinki, Finland. Wards were randomized to those in which staff received two 4-h interactive training sessions to recognize potentially harmful medications (intervention group) and a control group. Cognition (verbal fluency, clock-drawing test) was assessed at baseline and 6 and 12 months. The number of falls per resident over the 12-month follow-up was recorded.

resultsThe prevalence of harmful medication use declined in the intervention group {-11.7% [95% confidence interval (CI) -20.5 to -2.9]; p = 0.009}, but remained constant in the control group [+3.4% (95% CI -3.7 to 10.6); p = 0.34]. There were 171 falls in the intervention group (2.25 falls/person year, 95% CI 1.93-2.62) and 259 falls in the control group (3.25 falls/person year, 95% CI 2.87-3.67) [incidence rate ratio 0.72 (95% CI 0.59-0.88); p < 0.001]. Residents in the intervention group with a Mini-Mental State Examination (MMSE) score ≥10 had significantly less falls compared with respective residents in the control group (p < 0.001). Changes in verbal fluency or clock drawing test were not significantly different between the groups.

conclusionEducating nurses using activating learning methods can reduce the prevalence of harmful medications and the incidence of falls among residents in institutional settings.

Indexed as

Assisted Living FacilitiesAccidental FallsAgedAged, 80 and overCholinergic AntagonistsCognition DisordersDrug UtilizationFemaleFinlandHumansInappropriate PrescribingIncidenceMaleNursing StaffPrevalencePsychotropic DrugsCholinergic AntagonistsPsychotropic Drugs

Identifiers

PMID26446153
OpenAlexW1876206721

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.