MedSafer to Support Deprescribing for Residents of Long-Term Care: a Mixed-Methods Study.
clinical decision support system
deprescribing
long-term care
medication review
polypharmacy
Journal
Canadian geriatrics journal : CGJ
ISSN: 1925-8348
Titre abrégé: Can Geriatr J
Pays: Canada
ID NLM: 101579189
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
entrez:
24
6
2022
pubmed:
25
6
2022
medline:
25
6
2022
Statut:
epublish
Résumé
Polypharmacy is prevalent in long-term care homes (LTCH) and increases the risk of adverse drug events. Feasible and effective deprescribing interventions applicable in the LTCH environment are needed. We performed a mixed methods study to evaluate the feasibility, applicability, and effectiveness of an electronic deprescribing tool, MedSafer, to facilitate quarterly medication reviews (QMRs) on two pilot units in an academic long-term care home (LTCH). Chart reviews collected resident health data. The prevalence of deprescribing at a standard QMR was compared with a QMR conducted three months later with MedSafer. Feedback from physicians on their experience with MedSafer was obtained through semi-structured interviews. Physicians found MedSafer helpful in guiding deprescribing decisions and suggested software improvements to increase the feasibility in LTCH. The average number of medications deprescribed per resident was significantly higher at the MedSafer QMR (mean reduction = 1.1 medications, SD = 1.3) compared to the standard QMR (mean reduction = 0.5, SD = 0.9) (absolute difference of 0.5; SD 1.1; MedSafer has the potential to increase deprescribing in LTCHs by flagging potentially inappropriate medications. Integration in the electronic medical record might increase uptake in LTCHs. Further research should investigate the generalizability of MedSafer in a larger population and in non-academic LTCHs.
Sections du résumé
Background
UNASSIGNED
Polypharmacy is prevalent in long-term care homes (LTCH) and increases the risk of adverse drug events. Feasible and effective deprescribing interventions applicable in the LTCH environment are needed.
Methods
UNASSIGNED
We performed a mixed methods study to evaluate the feasibility, applicability, and effectiveness of an electronic deprescribing tool, MedSafer, to facilitate quarterly medication reviews (QMRs) on two pilot units in an academic long-term care home (LTCH). Chart reviews collected resident health data. The prevalence of deprescribing at a standard QMR was compared with a QMR conducted three months later with MedSafer. Feedback from physicians on their experience with MedSafer was obtained through semi-structured interviews.
Results
UNASSIGNED
Physicians found MedSafer helpful in guiding deprescribing decisions and suggested software improvements to increase the feasibility in LTCH. The average number of medications deprescribed per resident was significantly higher at the MedSafer QMR (mean reduction = 1.1 medications, SD = 1.3) compared to the standard QMR (mean reduction = 0.5, SD = 0.9) (absolute difference of 0.5; SD 1.1;
Conclusion
UNASSIGNED
MedSafer has the potential to increase deprescribing in LTCHs by flagging potentially inappropriate medications. Integration in the electronic medical record might increase uptake in LTCHs. Further research should investigate the generalizability of MedSafer in a larger population and in non-academic LTCHs.
Identifiants
pubmed: 35747414
doi: 10.5770/cgj.25.545
pii: cgj-25-175
pmc: PMC9156423
doi:
Types de publication
Journal Article
Langues
eng
Pagination
175-182Informations de copyright
© 2022 Author(s). Published by the Canadian Geriatrics Society.
Déclaration de conflit d'intérêts
CONFLICT OF INTEREST DISCLOSURES Drs. Todd C. Lee and Emily G. McDonald hold the copyright for the MedSafer software in conjunction with McGill University, and have received grant funding from the Canadian Institutes of Health Research, Centre for Aging and Brain Health Innovation, and Canadian Frailty Network related to the development of MedSafer. All other authors state that they are in no position of conflicts of interest that are directly relevant to the content of this article.
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