Development and use of a computer program to detect potentially inappropriate prescribing in older adults residing in Canadian long-term care facilities

BMC Geriatrics

Norman Flett⁷  George Heckman⁴  Nicole Ferko³  Sacha Dubois¹  Glenda Campbell⁶  Michel Bedard²  Alexandra Papaioannou⁵ 

[1] Department of Clinical Epidemiology and Biostatistics, McMaster University Hamilton, Ontario, Canada;Lakehead Psychiatric Hospital, Thunderbay, Ontario, Canada;Department of Clinical Health Sciences, McMaster University Hamilton, Ontario, Canada;Department of Medicine, McMaster University Hamilton, Ontario, Canada;Division of Geriatric Medicine, McMaster University Hamilton, Ontario, Canada;Medical Pharmacies Ltd. Pickering Ontario, Canada;St. Joseph's Villa Dundas, Ontario, Canada

关键词: elderly;    computer program;    drug database;    long-term care;    inappropriate prescribing;   

Others  :  858642
DOI  :  10.1186/1471-2318-2-5

 received in 2002-07-04, accepted in 2002-10-14,  发布年份 2002

【 摘 要 】

Background

Inappropriate prescribing has been estimated to be as high as 40% in long-term care. The purpose of this study was to develop a computer program that identifies potentially inappropriate drug prescriptions and to test its reliability.

Methods

Potentially inappropriate prescriptions were identified based on modified McLeod guidelines. A database from one pharmacy servicing long-term care facilities in Ontario was utilized for this cross-sectional study. Prescription information was available for the 356 long-term care residents and included: the date the prescription was filled, the quantity of drug prescribed and the eight-digit drug identification number. The pharmacy database was linked to the computer-based program for targeting potential inappropriate prescriptions. The computer program's reliability was assessed by comparing its results to a manual search conducted by two independent research assistants.

Results

There was complete agreement between the computer and manual abstraction for the total number of potentially inappropriate prescriptions detected. In total, 83 potentially inappropriate prescriptions were identified. Fifty-three residents (14.9%) received at least one potentially inappropriate prescription. Of those, twenty (37.7%) received two potential inappropriate prescriptions and eight (15.1%) received 3 or more potential inappropriate prescriptions. The most common potential inappropriate prescriptions were identified as long-term use of non-steroidal anti-inflammatory agents and tricyclic antidepressants with active metabolites.

Conclusion

A computer program can accurately and automatically detect inappropriate prescribing in residents of long-term care facilities. This tool may be used to identify potentially inappropriate drug combinations and educate health care professionals.

【 授权许可】

   
2002 Papaioannou et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

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