Enhancing Continuous Medication Safety Through e-Prescription and Clinical Decision Support Systems in Outpatient...

Area of Science:

• Health Services Research
• Pharmaceutical Sciences
• Gerontology

Background:

• Aging populations face increased multimorbidity and polypharmacy, elevating risks of drug-drug interactions and adverse events.
• Multiple healthcare providers complicate medication management, necessitating improved safety tools.
• Medication plans (MP), e-prescriptions, and clinical decision support systems (CDSS) can enhance medication safety and inform prescribing.

Purpose of the Study:

• To enhance medication therapy safety by integrating e-prescriptions, claims data, MPs, CDSS, and interprofessional communication.
• To evaluate the complex intervention's effectiveness, health-economic aspects, and implementation factors through a multiphase study.

Main Methods:

• A cluster-randomized controlled trial in phase 1 assessed process outcomes, with MP-claims data congruence as the primary outcome.
• Phase 2 employed a quasi-experimental design with a large patient cohort and synthetic control group, focusing on mortality and hospitalization.
• Mixed methods, including quantitative analyses of claims data and qualitative interviews, were utilized for comprehensive evaluation.

Main Results:

• Phase 1 recruited 187 patients (74 intervention, 113 control) by June 2025.
• Phase 2 data collection is ongoing until December 31, 2025, with final analyses planned for March 2027.
• Intervention effectiveness, cost-effectiveness, and implementation data are currently being collected and analyzed.

Conclusions:

• Medication safety in polypharmacy is a significant challenge in Germany.
• The eRIKA intervention shows promise for improving medication management.
• Multiperspective evidence supports the nationwide adoption of eRIKA for continuous medication therapy management.