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In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
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Medication in older patients reviewed multiple ways (MORE) study.

N A Zwietering1, D Westra2, B Winkens3

  • 1Department of Internal Medicine, Geriatric Medicine, Maastricht University Medical Centre, Maastricht University, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. anne.zwietering@mumc.nl.

International Journal of Clinical Pharmacy
|July 15, 2019
PubMed
Summary
This summary is machine-generated.

Medication reviews by geriatricians, pharmacists, and Clinical Decision Support Systems yield different insights. Combining these approaches offers a more thorough medication safety assessment for older patients.

Keywords:
Clinical Decision Support SystemElderlyMedication reviewNetherlandsPotentially inappropriate prescribing

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Area of Science:

  • Geriatric Medicine
  • Clinical Pharmacy
  • Health Informatics

Background:

  • Polypharmacy in older adults increases the risk of potentially inappropriate prescribing.
  • Effective medication review is crucial for ensuring safe and appropriate medication use in elderly patients.
  • Optimizing medication review processes can enhance patient safety and therapeutic outcomes.

Purpose of the Study:

  • To compare the quantity and types of medication-related remarks identified by geriatricians, outpatient pharmacists, and Clinical Decision Support Systems (CDSS).
  • To identify similarities and differences in medication review outcomes across different healthcare professionals and a CDSS.
  • To explore potential avenues for optimizing medication review strategies through a comparative analysis.

Main Methods:

  • A descriptive study was conducted at Zuyderland Medical Centre, a large teaching hospital in the Netherlands.
  • Medication reviews were performed by a geriatrician, an outpatient pharmacist, and a CDSS.
  • Remarks were categorized into seven pharmacotherapeutic problem types: indication issues, contraindications/interactions/side effects, dosage problems, duplicate medications, incorrect medications, and therapeutic drug monitoring.

Main Results:

  • Both the CDSS and outpatient pharmacist identified remarks in significantly more categories than geriatricians.
  • The CDSS generated more remarks on "double medication," "dosage problem," and "contraindication/interaction/side effects" compared to geriatricians.
  • Geriatricians identified more "medication without indication" remarks, while the CDSS identified more "contraindication/interaction/side effects" and "therapeutic drug monitoring" remarks than the outpatient pharmacist.

Conclusions:

  • Medication reviews conducted by geriatricians, outpatient pharmacists, and CDSS provide distinct and complementary insights.
  • Integrating the findings from these different review methods can lead to a more comprehensive understanding of a patient's medication profile.
  • A combined approach to medication review is recommended to enhance the detection of potential pharmacotherapeutic problems and improve patient safety.