Represcription After Adverse Drug Reaction in the Elderly: A Descriptive Study

Linden, Carolien M. J. van der; Kerskes, Marieke; Bijl, A. M. H.; Maas, Huub; Egberts, Toine C. G.; Jansen, Paul A. F.

doi:10.1001/archinte.166.15.1666

Cited by 61 publications

(50 citation statements)

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“…Studies have shown the possible consequences of inaccurate medication communication, for example the inappropriate restart of medication, that has been stopped during hospital admission due to adverse drug reactions [7, 8]. In order to improve the information transfer, policy documents outlining strategies to promote medication safety for patients moving from one care environment to another have been produced in the United Kingdom, the United States and recently in the Netherlands [9–11].…”

Section: Introductionmentioning

confidence: 99%

Informational needs of general practitioners regarding discharge medication: content, timing and pharmacotherapeutic advices

et al. 2010

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Objective To investigate the needs of Dutch general practitioners on discharge medication, both regarding content, timing and the appreciation of pharmacotherapeutic advices from clinical pharmacists. Setting A general teaching hospital in Amsterdam, the Netherlands. Method A prospective observational study was performed. A questionnaire with regard to the content, optimal timing (including way of information transfer) and appreciation of pharmacotherapeutic advices was posted to 464 general practitioners. One reminder was sent. Main outcome measure Description of the needs of general practitioners was assessed. For each question and categories of comments frequency tables were made. The Fisher-exact test was used to study associations between the answers to the questions. Results In total, 149 general practitioners (32%) responded. Most general practitioners (75%) experienced a delay in receiving discharge medication information and preferred to receive this on the day of discharge. GPs wished to receive this information mainly through e-mail (44%). There was a significant correlation (P = 0.002) between general practitioners who wanted to know whether and why medication had been stopped (87%) and changed (88%) during hospital admission. The general practitioners (88%) appreciated pharmacotherapeutic advices from clinical pharmacists. Conclusion This study indicates how information transfer on discharge medication to GPs can be optimised in the Netherlands. The information arrives late and GPs want to be informed on the day of discharge mainly by e-mail. GPs wish to know why medication is changed or discontinued and appreciate pharmacotherapeutic advices from clinical pharmacists.

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Section: Introductionmentioning

confidence: 99%

Informational needs of general practitioners regarding discharge medication: content, timing and pharmacotherapeutic advices

et al. 2010

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“…Adherence to the changes on the long run will probably be lower. When drugs have been discontinued because of adverse drug reactions, approximately a quarter are re-prescribed within 6 months [22]. This emphasizes the importance of concordance between geriatricians, general physicians, caregivers and patients on the reasons for discontinuing and restarting medication after CGA [23].…”

Section: Discussionmentioning

confidence: 99%

Do Geriatric Outpatients Adhere to Medication Changes Advised After Assessment? An Exploratory Pilot Study

Tulner

Frankfort²,

Wesselius³

et al. 2009

CCP

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“…To date the development of effective preventative strategies has been challenged by a lack of robust epidemiological data on patient and system-level risk factors for ADEs as well as the heterogeneity of clinical events observed. However, a prospective study enrolling a cohort of elderly patients admitted to hospital for an ADE indicated that a surprising 27% of patients were unintentionally reexposed to the culprit drug (the drug that caused the index ADE) within only six months of the initial event [8]. Similarly, Australian data indicate that up to 30% of ADEs requiring hospital admission consist of repeat events [9].…”

Section: Introductionmentioning

confidence: 99%

Designing an Adverse Drug Event Reporting System to Prevent Unintentional Reexposures to Harmful Drugs: Study Protocol for a Multiple Methods Design

Peddie¹,

Small²,

Badke³

et al. 2016

JMIR Res Protoc

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BackgroundAdverse drug events (ADEs) are unintended and harmful events related to medication use. Up to 30% of serious ADEs recur within six months because culprit drugs are unintentionally represcribed and redispensed. Improving the electronic communication of ADE information between care providers, and across care settings, has the potential to reduce recurrent ADEs.ObjectiveWe aim to describe the methods used to design Action ADE, a novel electronic ADE reporting system that can be leveraged to prevent unintentional reexposures to harmful drugs in British Columbia, Canada.MethodsTo develop the new system, our team will use action research and participatory design, approaches that employ social scientific research methods and practitioner participation to generate insights into work settings and problem resolution. We will develop a systematic search strategy to review existing ADE reporting systems identified in academic and grey literature, and analyze the content of these systems to identify core data fields used to communicate ADE information. We will observe care providers in the emergency departments and on the wards of two urban tertiary hospitals and one urban community hospital, in one rural ambulatory care center, and in three community pharmacies in British Columbia, Canada. We will also conduct participatory workshops with providers to understand their needs and priorities related to communicating ADEs and preventing erroneous represcribing or redispensing of culprit medications. These methods will inform the iterative development of a preliminary paper-based reporting form, which we will then pilot test with providers in a real-world setting.ResultsThis is an ongoing project with results being published as analyses are completed. The systematic review has been completed; field observations, focus groups, and pilot testing of a preliminary paper-based design are ongoing. Results will inform the development of software that will enable clinically useful user-friendly documentation and communication of ADEs.ConclusionsWe take this approach with the recognition that information technology-based solutions in health care often fall short of expectations as a result of designers’ failure to account for organizational and work practice considerations, and the needs of end-users. We describe how integrating qualitative methods into an iterative participatory design process (planned in partnership with end-users) will allow us to address specific clinical needs, conceptualize linkages between systems, integrate the reporting system into clinicians’ workflow, and design the system to optimize its uptake into practice.

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Represcription After Adverse Drug Reaction in the Elderly: A Descriptive Study

Cited by 61 publications

References 3 publications

Informational needs of general practitioners regarding discharge medication: content, timing and pharmacotherapeutic advices

Informational needs of general practitioners regarding discharge medication: content, timing and pharmacotherapeutic advices

Do Geriatric Outpatients Adhere to Medication Changes Advised After Assessment? An Exploratory Pilot Study

Designing an Adverse Drug Event Reporting System to Prevent Unintentional Reexposures to Harmful Drugs: Study Protocol for a Multiple Methods Design

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