Estimating Risk Factors for Patients with Potential Drug-Related Problems Using Electronic Pharmacy Data

Isaksen, Sune Faurschou; Jonassen, Jacob; Malone, Daniel C.; Billups, Sarah J.; Carter, Barry L.; Sintek, Charles D.

doi:10.1345/aph.18268

Cited by 21 publications

(21 citation statements)

References 23 publications

(23 reference statements)

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“…Older adults’ risk of potential adverse drug interactions (PADI) is greatly increased when they have three or more chronic illnesses, take five or more concurrent medications, ingest more than 12 medication doses taken per day, have a history of nonadherence, or take a drug that requires therapeutic monitoring (Isaksen et al 1999). In the current study, 53.7% of the participants had three or more chronic illnesses, 98% reported taking five or more different medications in the past month (combining both Rx and OTC medications), and 9.5% took 12 or more medication doses per day.…”

Section: Discussionmentioning

confidence: 99%

Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension: Results of an e-health Clinical Efficacy Trial

Neafsey

M'Lan

et al. 2010

Ageing Int

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A randomized controlled efficacy trial targeting older adults with hypertension (age 60 and over) provided an e-health, tailored intervention with the “next generation” of the Personal Education Program (PEP-NG). Eleven primary care practices with advanced practice registered nurse (APRN) providers participated. Participants (N=160) were randomly assigned by the PEP-NG (accessed via a wireless touchscreen tablet computer) to either control (entailing data collection and four routine APRN visits) or tailored intervention (involving PEP-NG intervention and four focused APRN visits) group. Compared to patients in the control group, patients receiving the PEP-NG e-health intervention achieved significant increases in both self-medication knowledge and self-efficacy measures, with large effect sizes. Among patients not at BP targets upon entry to the study, therapy intensification in controls (increased antihypertensive dose and/or an additional antihypertensive) was significant (p=.001) with an odds ratio of 21.27 in the control compared to the intervention group. Among patients not at BP targets on visit 1, there was a significant declining linear trend in proportion of the intervention group taking NSAIDs 21–31 days/month (p=0.008). Satisfaction with the PEP-NG and the APRN provider relationship was high in both groups. These results suggest that the PEP-NG e-health intervention in primary care practices is effective in increasing knowledge and self-efficacy, as well as improving behavior regarding adverse self-medication practices among older adults with hypertension.

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Section: Discussionmentioning

confidence: 99%

Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension: Results of an e-health Clinical Efficacy Trial

Neafsey

M'Lan

et al. 2010

Ageing Int

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“…32 All of the participants in this study were at increased risk of PADI. Seven (64%) had three or more chronic diseases.…”

Section: Discussionmentioning

confidence: 90%

Beta Testing of a Network-Based Health Literacy Program Tailored for Older Adults With Hypertension

Neafsey

Anderson

Peabody

et al. 2008

CIN: Computers, Informatics, Nursing

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A touch screen–enabled “Personal Education Program” was modified to the “next generation” to capture self-medication behaviors of older adults with hypertension and assess related knowledge and self-efficacy. The program analyzes patient-entered information and delivers interactive educational content tailored to the reported behaviors. Summaries of self-reported symptoms, medication use (including frequency/time), drug interactions, and corrective strategies with an illustration of the drug interaction are printed to inform the provider before the primary care visit and for the patient to take home for self-study. After formative research during development and formal diagnostic and verification usability studies with advanced practice nurses and older adults, a beta test was conducted with older adults with hypertension over a 3-month period. Findings from the beta test suggest that older adult user satisfaction was high. Blood pressure declined over the four visits for 82% of the participants. The next generation of the Personal Education Program had a large effect size in increasing knowledge and self-efficacy for avoiding adverse self-medication behaviors. Behavior risk score did not change significantly but was significantly correlated with systolic blood pressure on the fourth visit. The positive results found in this small sample suggest that the next generation of the Personal Education Program could play a central role in facilitating patient-provider communication and medication adherence.

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“…A different approach to lower the risk of drug‐drug interactions incidence involves the use of computer‐based programs to identify patients at high risk for drug‐related problems. These systems have proven useful for clinical pharmacists in providing pharmaceutical services to patients who are most likely to benefit (Isaksen et al . 1999; Halkin et al .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Drug‐Drug Interaction Alert Structure through the Retrospective Analysis of Statins‐Macrolides Co‐Prescriptions

Morera

Gervasini

Carrillo

et al. 2005

Basic Clin Pharma Tox

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The aim of this work was the evaluation of the existent drug interaction alert structure in Spain, which is based on yellow cards notifications and circulation of drug alert letters, through the retrospective analysis of CYP3A-metabolized statins and macrolides co-prescriptions in the Spanish province of Badajoz between May and September 2001. The period of study was planned to include the release of 2 drug alert letters released by the Spanish Drug Agency in June and July, addressed to all healthcare professionals, which warned against the concomitant prescription of statins and inhibitors of their metabolism, e.g. macrolides antibacterials. 4,600,764 prescriptions were examined, 664 of which corresponded to combinations of statins and macrolides. Although a decrease was detected in the number of these co-prescriptions throughout the study, 80 of these corresponding to 67 patients were still being prescribed in September, after the warnings by the Spanish Drug Agency had been released. 431 physicians prescribed these drugs simultaneously, with 22.9% of them having more than one patient at potential risk. Doctors working at rural healthcare centres or not directly attached to any healthcare facility were more prone to prescribe unsafe coprescriptions than those working at urban health centre. This study shows that the present drug alert system is not fully efficient when facing a situation like the one retrospectively reviewed in this study, in which a prompt action, in this case termination of potentially hazardous coprescriptions, was required. New systems developed to improve prescribing, including a new method based on personal contact between Drug Surveillance Centres and general practitioners, are discussed.

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Estimating Risk Factors for Patients with Potential Drug-Related Problems Using Electronic Pharmacy Data

Cited by 21 publications

References 23 publications

Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension: Results of an e-health Clinical Efficacy Trial

Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension: Results of an e-health Clinical Efficacy Trial

Beta Testing of a Network-Based Health Literacy Program Tailored for Older Adults With Hypertension

Evaluation of a Drug‐Drug Interaction Alert Structure through the Retrospective Analysis of Statins‐Macrolides Co‐Prescriptions

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