Navigation Links
Is it Possible to Change Prescribing Habits?

In the US more than 770,000 people are injured or die each year in hospitals from adverse drug events (ADEs), which can cost a hospital, depending on its size, about US$5.6 million every year, excluding ADE-associated costs for malpractice and litigation and the personal costs of injuries to patients.

Nationally, hospital expenses to treat patients who have ADEs during hospital admission are enormous: between $1.6 billion and $5.6 billion annually. The cost to patients is also high and not just monetary: those who have an ADE spend on average 8?2 days longer in the hospital than patients who do not have an ADE, and their admission costs $16,000 to $24,000 more.

One way for hospitals to tackle the problem of medication errors is to install computerized monitoring systems, which can reduce ADEs by 28%?5%. Apart from the obvious benefits to patients, these systems can save hospitals as much as $500,000 annually in direct costs. However, despite the potential, fewer than 10% of hospitals have implemented such systems.

Less is known about the value of such systems in an outpatient setting. Now, Andrew Steele and colleagues from Denver have tested a computerized physician order entry (CPOE) system in a US hospital's outpatient clinic. The main purpose of the study was to determine the impact of using computerized alerts to improve the prescribing of medications in the outpatient setting. Studies have shown that 18%?5% of patients might have an ADE in the outpatient environment. This study evaluated a CPOE system alongside an integrated computer-based clinical-decision support system.

It focused on a very specific type of clinical-decision support system: the use of a rules technology to prevent drug–laboratory ADEs. The way the system worked was that providers ordered medications on a computer and an alert was displayed if a relevant drug–laboratory interaction existed.

Comparisons were made between baseline and post-intervention per iods. Provider ordering behavior was monitored, focusing on the number of medication orders not completed and the number of rule-associated laboratory test orders initiated after alert display. The investigators found that the rule processed 16,291 times during the study period on all possible medication orders: 7,017 during the pre-intervention period (prescribing doctors did not receive alerts) and 9,274 during the post-intervention period (prescribing doctors received alerts). During the post-intervention period, an alert was displayed for 11.8% (1,093 out of 9,274) of the times the rule processed, with 5.6% of alerts being for “missing laboratory values,?6.0% for “abnormal rule-associated laboratory?values, and 0.2% for both types of problems.

Providers did pay attention to the alerts; they increased ordering of the rule-associated laboratory test when an alert was displayed (39% at baseline versus 51% post-intervention, p < 0.001), thus showing that the rules had a significant ability to change the ordering behavior of the provider, said the authors. The strongest effect occurred when providers where alerted to “missing?laboratory results (42% increase), the investigators noted. There was less of an effect on ordering behavior when the alert informed the provider of the existence of an abnormal laboratory value (23% increase), which may imply that the cutoff values for the “abnormal?trigger were set too low, suggested the authors. However, there was only a modest effect on halting the ordering of medications, and this was limited to occasions in which the alert presented an abnormal laboratory value in which case there was almost a doubling in order cessation.

There are limitations to the study. For example, the intervention focused on a specific group of drug–laboratory interactions and thus the results may not be generalizable to other types of interventions. In addition, the setting was a single primary-care clinic outpatient setting within a large public-health-integrated health-care delivery system, and results may be different in other settings such as hospitals and private physician offices. However, changing prescriber practice at all is not easy to achieve and this approach thus warrants further research.


'"/>

Source:PLoS Medecine


Related biology news :

1. Stem Cells Found In Cerebellum; Possible Cell of Origin for Childhood Brain Tumors
2. Possible treatment found for chemobrain
3. Possible brain hormone may unlock mystery of hibernation
4. Possible birthplace of malignant brain tumors identified
5. Iron Deficiency Sparks Dramatic Changes In Gene Expression
6. Scientists Propose Sweeping Changes to Naming of Bird Neurosystems to Acknowledge Their True Brainpower
7. FDA Announces Series of Changes to the Class of Marketed Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
8. Some Brain Cells Change Channels To Fine-tune The Message
9. Some Brain Cells Change Channels
10. Change in gene may be underlying molecular defect in some colorectal cancers
11. Methamphetamine Abuse, HIV Infection Cause Changes in Brain Structure
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:4/17/2017)... , April 17, 2017 NXT-ID, Inc. (NASDAQ: ... announces the filing of its 2016 Annual Report on Form 10-K ... Commission. ... 10-K is available in the Investor Relations section of the Company,s ... the SEC,s website at http://www.sec.gov . 2016 Year ...
(Date:4/11/2017)... 11, 2017 Crossmatch®, a globally-recognized leader ... today announced that it has been awarded a ... Activity (IARPA) to develop next-generation Presentation Attack Detection ... "Innovation has been a driving force within Crossmatch ... allow us to innovate and develop new technologies ...
(Date:4/11/2017)... NXT-ID, Inc. (NASDAQ:   NXTD ) ("NXT-ID" or ... independent Directors Mr. Robin D. Richards and Mr. ... the company,s corporate governance and expertise. ... Gino Pereira , Chief Executive Officer said," ... and benefiting from their considerable expertise as we move forward ...
Breaking Biology News(10 mins):
(Date:5/24/2017)... WASHINGTON, DC, USA (PRWEB) , ... May 23, 2017 , ... ... the economy as well as an enabler of life-saving medical and other vital technologies ... and photonics . They joined others in the scientific community today in responding to ...
(Date:5/24/2017)... BOSTON , May 23, 2017 As Ebola ... with four deaths and 20 suspected cases now reported, ... via the PubMed database, showed a correlation between the 2014 ... gene Replikin counts rose sharply in 2012-13, which preceded the ... rise in the Ebola gene Replikin counts in 2014-15, which ...
(Date:5/23/2017)... ... ... A recent survey conducted by the Weed Science Society of America (WSSA) ranks ... of broadleaf crops, fruits and vegetables, while common lambsquarters ranks as the weed most ... the 2016 survey, the second conducted by WSSA. A 2015 baseline survey explored ...
(Date:5/23/2017)... , ... May 23, 2017 , ... ... this month its 20th anniversary, marking the occasion with a strong presence at ... meeting’s Welcome Reception and further extends an invitation to all attendees to view ...
Breaking Biology Technology: