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A Pharmacist-Physician Intervention Model Using a Computerized Alert System to Reduce High-Risk Medication Use in Elderly Inpatients. | LitMetric

AI Article Synopsis

  • - The study focused on improving medication safety for elderly patients in hospitals by using a pharmacist-physician collaboration to reduce the use of potentially inappropriate medications (PIMs).
  • - A computerized alert system (CAS) flagged high-risk medications during hospital stays, leading to significant interventions; 74.5% of alerts were deemed clinically relevant, resulting in a 77.7% change rate in medication management.
  • - The findings highlighted that the intervention model effectively decreased high-risk medication use and that many patients benefiting from alert reviews were not typically assessed by the geriatric consultation team.

Article Abstract

Background: Prescription is a complex challenge facing clinicians caring for elderly inpatients. Potentially inappropriate medication (PIM) use frequently leads to adverse drug events and geriatric syndromes. Strategies to reduce PIM use are thus urgently needed.

Objectives: The objectives of this study were to assess (1) the applicability of a pharmacist-physician intervention model to reduce the use of high-risk medications; and (2) the clinical relevance of the alerts generated by a computerized alert system (CAS).

Methods: The study was conducted in patients aged 65 years or older admitted to a teaching hospital between April and June 2014. In the intervention model, the pharmacist determined the clinical relevance of the Beers criteria-based CAS alerts, analyzed the patient's pharmacotherapy, and developed a geriatric pharmacotherapeutic plan to be discussed with the treating physician. The main outcome was the change rate, defined as the number of patient-days with a change in at least one medication out of the number of patient-days with a pharmacist intervention.

Results: The CAS identified at least one alert in 200 patient-days, i.e., 4.3% of screened patient-days. In 74.5% of those patient-days, at least one alert was judged to be clinically relevant. The change rate was 77.7%. The most frequent changes were drug discontinuation (42.4%) and dose reduction (29.1%). The inpatient geriatric consultation team was involved in only 24% of the hospitalizations with at least one change in medication.

Conclusion: The intervention model reduced high-risk medication use in older inpatients. Most of the vulnerable inpatients identified by CAS alerts would not have otherwise had a geriatric medication review.

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Source
http://dx.doi.org/10.1007/s40266-015-0286-5DOI Listing

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