| Preventing potentially inappropriate medication use in hospitalized older patients with a computerized provider order entry warning system. | |
| | |
MedLine Citation:
|
PMID: 20696957 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Potentially inappropriate medication (PIM) use in hospitalized older patients is common. Our objective was to determine whether a computerized provider order entry (CPOE) drug warning system can decrease orders for PIMs in hospitalized older patients. METHODS: We used a prospective before-and-after design among patients 65 years or older admitted to a large, urban academic medical center in Boston, Massachusetts, from June 1, 2004, through November 29, 2004 (for patients admitted before the warning system was added), and from March 17, 2005, through August 30, 2008 (patients admitted after the warning system was added). We instituted a medication-specific warning system within CPOE that alerted ordering providers at the point of care when ordering a PIM and that advised alternative medication or dose reduction. The main outcome measure was the rate of orders for PIMs before and after the warning system was deployed. RESULTS: The mean (SE) rate of ordering medications that were not recommended dropped from 11.56 (0.36) to 9.94 (0.12) orders per day after the implementation of a CPOE warning system (difference, 1.62 [0.33]; P<.001), with no evidence that the effect waned over time. There were no appreciable changes in the rate of ordering medications for which only dose reduction was recommended or that were not targeted after CPOE implementation. These effects persisted in autoregressive models that accounted for secular trends and season (P<.001). CONCLUSION: Specific alerts embedded into a CPOE system, used in patients 65 years or older, can decrease the number of orders of PIMs quickly and specifically. |
| | |
Authors:
|
Melissa L P Mattison; Kevin A Afonso; Long H Ngo; Kenneth J Mukamal |
Related Documents
:
|
17208857 - Word from the front lines: injured worker organizations speak out. 8130507 - Goals for concept representation in the galen project. 10300767 - Strategic importance of mis for home healthcare. 15994227 - Soluble epoxide hydrolase is a therapeutic target for acute inflammation. 3057047 - Eosinophilic nonallergic rhinitis. 19920437 - Transient global amnesia-like episode due to mistaken intake of zolpidem: drug safety c... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: Archives of internal medicine Volume: 170 ISSN: 1538-3679 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2010 Aug |
Date Detail:
|
Created Date: 2010-08-10 Completed Date: 2010-09-01 Revised Date: 2011-04-26 |
Medline Journal Info:
|
Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: United States |
Other Details:
|
Languages: eng Pagination: 1331-6 Citation Subset: AIM; IM |
Affiliation:
|
Division of Gerontology, Department of Medicine, Palmer-Baker Span 2, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA. mmattiso@bidmc.harvard.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Academic Medical Centers Aged Aged, 80 and over Boston Confounding Factors (Epidemiology) Drug Prescriptions* Female Humans Inpatients / statistics & numerical data* Male Medical Order Entry Systems / utilization* Medication Errors / prevention & control* Prospective Studies Urban Population / statistics & numerical data |
| Grant Support | |
ID/Acronym/Agency:
|
1 UL1 RR025758-01/RR/NCRR NIH HHS |
| Comments/Corrections | |
Comment In:
|
Arch Intern Med. 2011 Mar 14;171(5):473-4; author reply 474
[PMID:
21403049
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Impact of Medicare Part D on seniors' out-of-pocket expenditures on medications.
Next Document: Spectrum of cancer risk late after AIDS onset in the United States.