Apr
18
2012

Adverse drug reactions (ADRs) are serious threats in nursing home and assisted living facilities where the advanced age and poor health of most patients make them more vulnerable than the general population. This effect is compounded by many patients taking multiple medications significantly increasing the possibility of an adverse event.

According to a study by Warwick Medical School in England, the typical nursing home patient takes an average of nine medications. The same study found 90% of patients were exposed to some kind of medication error, and 52% were exposed to serious errors. A recent study by the School of Pharmacy at Belfast University in Ireland found that during a 16 week period, nursing home patients with dementia (who are more vulnerable because of the inability to advocate for themselves), 40% were prescribed at least one potentially inappropriate medication.

According to a report by Meyers Primary Care Institute, the Fallon Healthcare System and the University of Massachusetts Medical School, the role of watchdog often  falls to family members demanding physicians and staff t review their family member’s medication regimens. Family involvement is usually a good thing for total patient care. However, family involvement adds to the burden of the staff who must spend extra time communicating with family members. According to the Journal of Aging Studies, this often becomes a contentious process. Staff-family interactions are described as “difficult, problematic and time consuming.”

According to a 2006 pilot study of long term care facilities referenced in the Journal of the American Health Information Management Association, physicians and nursing homes have access to the power of e-prescribing reducing the probability of medication errors and freeing up staff to spend more time with patients. E-prescribing provides access to an interactive database incorporating patient records along with regularly updated information about drugs and drug interactions. As a result:

  • Drugs that interact adversely with patient’s existing prescriptions are red-flagged alerting staff.
  • Physicians and staff have a complete record of a patient’s drugs including those prescribed by their colleagues. Physicians are better able to advise family members about their loved one’s health condition and whether or not the symptoms are related to drug interactions.
  • Doctors are better able to determine if the patient is taking unnecessary drugs resulting, where possible, in a reduction in the number of prescriptions.
  • The system lets the physician know of safe and effective generic alternatives saving money for the patients.
  • Prescriptions are legible and more likely to be correctly dispensed and administered.
  • Since the staff spends less time on processing prescription renewals, they have more time to spend with patients.

According to recent survey results published by McKnight’s Long Term Care News & Assisted Living, improved patient safety and life quality may explain why most long term care administrators named e-prescribing the technology they most likely would adopt.

About Peter Kaufman:

Schooled at MIT, Dr. Kaufman nurtured a strong interest in medical informatics while a Bowman Gray School of Medicine faculty member. After entering private practice he founded PiNK software in 1996 to produce EMR software, later becoming DrFirst’s chief medical officer upon its founding. He lectures nationally on various healthcare IT topics, and as a board certified gastroenterologist, he continues a limited clinical practice. Dr. Kaufman is a member of the Health IT Standards Committee, Privacy and Security Workgroup for ONC (Office of the National Coordinator for Healthcare Information Technology). Representing the American Gastroenterology Association’s (AGA), Dr. Kaufman is a delegate to the AMA and was the co-chair of the Physicians Electronic Health Record Consortium (PEHRC). He has participated on workgroups at CCHIT (stand-alone e-prescribing), HIMSS (e-prescribing), and NCPDP (e-prescribing).

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