Optimizing Medication History Value in Clinical Encounters with Elderly Patients

Brown University, Providence RI

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Linked publications & trials

Abstract

E-prescribing with medication history at the point of prescribing may very well assist[unreadable] physicians in understanding more fully adherence issues with older patients, thus promoting[unreadable] partnership with patients, empowering patients to participate in treatment decisions, and negotiating[unreadable] acceptable medication regimens that are more amenable to patient follow-through. Information[unreadable] regarding medication history provided by community pharmacy chain organizations in real-time, as[unreadable] well as the potential for communication from the pharmacy when a prescription has not been filled is[unreadable] currently available in some e-prescribing systems in selected geographic locations. Stemming from[unreadable] our previous research, we hypothesized that to optimize improvements in quality of medication[unreadable] management in during clinician office visits clinicians need additional professional development to[unreadable] better use the medication history in the clinical encounter. We also hypothesized that additional[unreadable] clinical informatics must be used in conjunction with the flow of detailed medication history via eprescribing[unreadable] to help guide and structure the clinician?s approach to medication management in[unreadable] ambulatory settings. The Specific Aims are:[unreadable] 1. To develop geriatric-specific algorithms to identify potential issues with medication[unreadable] management (e.g. polypharmacy, potentially inappropriate medication use, duplicative therapy, nonadherence)[unreadable] using community-pharmacy generated medication history.[unreadable] 2. For common issues identified by the algorithms developed in aim 1, to develop structured,[unreadable] problem-oriented frameworks for organizing medication history information during visits (triggering).[unreadable] 3. To develop and pretest modules to teach clinicians how to improve geriatric patient-provider[unreadable] communication relating to medication management with the use of technology (training).[unreadable] 4. To test the impact of these interventions on clinician behavior using a randomized controlled[unreadable] trial with three arms: a) no intervention, b) delivery triggering intervention; and c) delivery of triggering[unreadable] and training interventions.[unreadable] 5. To develop a "tool-kit" resources that include developed intervention products for use by nonphysician[unreadable] providers in other ambulatory settings (e.g. pharmacists in community pharmacy settings).