Medication reviews with computerised expert support: evaluation of a method to improve the quality of drug utilisation in the elderly.
Int J Health Care Qual Assur
; 23(6): 571-82, 2010.
Article
en En
| MEDLINE
| ID: mdl-20845823
ABSTRACT
PURPOSE:
This paper aims to examine whether a computerised system for medication reviews can support physicians' decisions and improve the quality of drug treatment in the elderly. DESIGN/METHODOLOGY/APPROACH:
This is a descriptive intervention study. The study included 275 patients living in community settings and nursing homes in Stockholm, Sweden. Patient data were analysed using computer software and scrutinised by a clinical pharmacologist. Pharmaco-therapeutic advice was sent to the physician responsible for each patient. The main outcome measures were initiation and discontinuation of drugs, changes of doses and rates of identified drug-related problems.FINDINGS:
Expert opinions were given by the clinical pharmacologist, for 275 patients, mean age 85 years; 70 per cent female. An average of 3.3 remarks was given concerning unsuitable drugs, unclear indication, dosing when the kidney function was decreased, drug-drug interactions and quality indicators. On average 1.5 drug-related problems (DRP) per patient were attended to by the responsible physician at each unit. The most common action taken was withdrawal of a drug (n = 208). On average the drug use decreased from 10.4 to 9.5 drugs per patient, and several quality indicators were met. The drug costs decreased, and resulted in a more cost-effective drug therapy. ORIGINALITY/VALUE The paper develops and tests a method for intervention in the care of elderly patients. The method is based on a computerised expert support system for medication reviews at a distance and on education of the staff. A safer drug therapy with improved quality and cost-effectiveness is thus provided.
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Banco de datos:
MEDLINE
Asunto principal:
Garantía de la Calidad de Atención de Salud
/
Revisión de la Utilización de Medicamentos
/
Servicios de Información sobre Medicamentos
Tipo de estudio:
Prognostic_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Int J Health Care Qual Assur
Asunto de la revista:
PESQUISA EM SERVICOS DE SAUDE
Año:
2010
Tipo del documento:
Article
País de afiliación:
Suecia