Reduction in targeted potentially inappropriate medication use in elderly inpatients: a pragmatic randomized controlled trial

Abstract

In hospitalized older adults, a CAS-based pharmacist-physician intervention, compared to usual clinical care, resulted in significant higher number of drug cessation and dosage reductions for targeted PIMs.

Multicomponent Interventions Reduce High‐Risk Medications for Delirium in Hospitalized Older Adults

“…Another contributing factor was the technology‐assisted medication review by pharmacists. Several studies have demonstrated the positive effect of pharmacist interventions, which leverage computerized clinical alert systems to reduce patient exposure to PIMs . Two studies reported high acceptance rates (78%) of recommendations that pharmacists made to prescribers for medication changes based on medication alerts they deemed clinically relevant .…”

“…Several studies have demonstrated the positive effect of pharmacist interventions, which leverage computerized clinical alert systems to reduce patient exposure to PIMs. [31][32][33][34] Two studies reported high acceptance rates (78%) of recommendations that pharmacists made to prescribers for medication changes based on medication alerts they deemed clinically relevant. 31,33 The conservative change rate of 30% reported in our program is probably due to the inclusion of all medication alerts that the EPS software generated regardless of clinical relevance.…”

To give or not to give: no dearth of explicit guidelines on potentially inappropriate prescribing of non‐steroidal anti‐inflammatory drugs to older adults

“…In healthcare systems where electronic prescribing is the norm, such alerts may be a cost-saving, manpower-lean strategy to improve care of the older adult. 7,8 However, it may be challenging to prove that such models of care work effectively as implementation issues may hamper the actual roll out of the models of care. In particular, the effectiveness of such a strategy will depend on improving usability and the alertuser interface to reduce 'click burden' (more steps required to complete a prescription) and 'alert fatigue' (multiple alerts causing user frustration).…”

“…Taking this further, such risk prediction models may be incorporated into electronic medication alerts so that evidence‐based guidelines are integrated into clinical information systems to reduce inappropriate NSAID prescriptions in vulnerable older adults. In healthcare systems where electronic prescribing is the norm, such alerts may be a cost‐saving, manpower‐lean strategy to improve care of the older adult . However, it may be challenging to prove that such models of care work effectively as implementation issues may hamper the actual roll out of the models of care.…”

O uso de medicamentos potencialmente inapropriados e a ocorrência de quedas e hospitalizações em idosos ambulatoriais após condição aguda: estudo de coorte retrospectivo

“…A identificação dos MPI em uso é considerada uma das estratégias para a melhoria da prescrição de idosos, seja para a promoção de desprescrição ou monitoramento para os casos em que o uso é considerado apropriado 50,66 .…”