242848 Alternatives to potentially inappropriate medications for use in e-prescribing software: Triggers and treatment algorithms

Tuesday, November 1, 2011: 4:50 PM

Kate L. Lapane, PhD , Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Anne L. Hume, PharmD, FCCP, BC , College of Pharmacy, University of Rhode Island, Kingston, RI
Brian Quilliam, PhD , Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI
Charles B. Eaton, MD , Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI
Roberta Goldman, PhD , Center for Primary Care and Prevention, Brown University, Pawtucket, RI
Background: A high proportion of adverse effects in older adults is due to inappropriate medication usage.

Objective: To describe the development of evidence-based e-prescribing triggers and treatment algorithms for potentially inappropriate medications for older adults

Methods: A literature review and sessions with an expert panel and two focus groups (n=29) were conducted to assess needs for software of primary care providers using electronic prescribing software, and systems receiving medication history. Standardized treatment algorithms for clinicians attempting to prescribe potentially inappropriate medications for their older patients and poor adherence triggers were designed. 15 treatment algorithms were developed suggesting alternative therapies and targeted adherence triggers.

Results. Evidenced-based treatment algorithms were well received by primary care physicians. Providing alternatives to potentially inappropriate medications would make it easier for physicians to change decisions at the point of prescribing.

Conclusion. Prospectively identifying and intervening on older persons receiving potentially inappropriate medications or with adherence issues may prevent adverse drug events.

Learning Areas:
Communication and informatics

Learning Objectives:
1) Describe problems with potentially inappropriate medication use in a primary care setting 2) Describe potential tools available in e-prescribing software to harness the power of medication history 3) Describe use of triggers and treatment algorithms to provide alternatives to inappropriate medication use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Lapane is an epidemiologist who has over 10 years experience designing and implementing health IT solutions for older adults.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.