在急诊室实施老年临床决策支持,用于可能不合适的药物
Gina A Elder1, Kevin King1, Marc Willner1
1Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.
概括
基于电子健康记录 (EHR) 的老年临床决策支持 (CDS) 改善了在急诊室 (ED) 的老年人对潜在不合适药物 (PIM) 的建议的遵守. 这种干预增加了对ED命令和释放处方的适当处方.
科学领域:
- 老年人药理学老年人药理学
- 医疗信息学 医疗信息学
- 紧急医疗 紧急医疗
背景情况:
- 在老年人中,潜在不合适的药物 (PIM) 与不良事件和再接收有关.
- 紧急诊所 (ED) 是老年患者药物管理的关键点.
研究的目的:
- 评估基于电子健康记录 (EHR) 的老年临床决策支持 (CDS) 对老年人遵守老年人PIM建议的影响.
- 评估ED访问期间和出院时订购的药物的CDS有效性.
主要方法:
- 一个多中心前后实施队列研究设计.
- 对12个目标PIM在基于EHR的 Geriatric CDS实施之前和之后遵守老年医疗建议的比较.
- 对65岁及以上患者的ED处方和出院处方的分析.
主要成果:
- 对于ED命令 (52%至71%) 和出院处方 (0.5%至31.7%) 实施后,遵守老年CDS建议的情况显著增加.
- 对于ED订单,CDS订单面板的使用率为62.1%,对于出院处方的使用率为36.7%.
- 在使用CDS面板的订单中,合规率很高 (ED订单90%;排放处方80.4%).
结论:
- 基于EHR的老年CDS有效地提高了对ED中老年人的药物治疗建议的遵守.
- 该干预措施表明,在紧急护理期间和之后对老年患者的药物安全性产生了积极影响.
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