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Alternatives to potentially inappropriate medications for use in e-prescribing software: triggers and treatment algorithms
  1. Anne L Hume1,
  2. Brian J Quilliam1,
  3. Roberta Goldman2,3,
  4. Charles Eaton2,3,
  5. Kate L Lapane4
  1. 1Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
  2. 2Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island, USA
  3. 3Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
  4. 4Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA
  1. Correspondence to Kate L Lapane, Department of Epidemiology and Community Health, Virginia Commonwealth University, 830 East Main Street, Fifth Floor, Richmond, VA 23298, USA; kllapane{at}vcu.edu

Abstract

Objective To describe the development of evidence-based electronic prescribing (e-prescribing) triggers and treatment algorithms for potentially inappropriate medications (PIMs) for older adults.

Design Literature review, expert panel and focus group.

Setting Primary care with access to e-prescribing systems.

Participants Primary care physicians using e-prescribing systems receiving medication history.

Interventions Standardised treatment algorithms for clinicians attempting to prescribe PIMs for older patients.

Main outcome measure Development of 15 treatment algorithms suggesting alternative therapies.

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

Conclusion Prospectively identifying older persons receiving PIMs or with adherence issues and providing feasible interventions may prevent adverse drug events.

  • Adverse drug events
  • geriatrics
  • inappropriate medications
  • primary care
  • adverse event
  • ambulatory care
  • drug therapy
  • medication safety

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjqs.2010.049635

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    Footnotes

    • Funding This study was supported in part by a grant from the Agency of Healthcare Research and Quality (1R18 HS017150) (Agency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850) and the award number UL1RR031990 from the National Center for Research Resources, National Institutes of Health (9000 Rockville Pike Bethesda, MD 20892, USA). The funders had no involvement in the study design; in the collection, analysis and interpretation data; in the writing of the report; and in the decision to submit the paper for publication. Other Funders: NIH.

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval This study was conducted with the approval of the Virginia Commonwealth University and Memorial Hospital of Rhode Island.

    • Provenance and peer review Not commissioned; externally peer reviewed.