Improving quality of NSAID prescribing by internal medicine trainees with an educational intervention

Background: Prescribing nonsteroidal anti-inflammatory drugs (NSAIDs) for older adults is a safety concern. Education innovations in postgraduate training designed to improve patient safety should comply with the Accreditation Council for Graduate Medical Education (ACGME). Purpose: The objective is to evaluate a seven-component education program for internal medicine trainees designed to change prescribing practices while addressing ACGME competencies. Methods: Pretest, posttest data collection. Results: The baseline chart review found that 28.7% (79/275) patients age 70 or older were prescribed NSAIDs. Approximately 1 year later, the proportion of patients prescribed NSAIDs had declined to 16.4% (30/183; p = .002). The proportion of patients prescribed NSAIDs in conjunction with a diuretic similarly declined from 13.6% (38/278) to 7% (13/187; p=024). Conclusion: A systematically applied education program targeted to a specific prescribing pattern produced significant improvement among internal medicine trainees. This model may assist training programs in reducing polypharmacy, or in other areas of trainee practice.