PMID- 23943248
OWN - NLM
STAT- MEDLINE
DCOM- 20140710
LR  - 20220409
IS  - 1179-1969 (Electronic)
IS  - 1170-229X (Linking)
VI  - 30
IP  - 10
DP  - 2013 Oct
TI  - Prevention of inappropriate prescribing in hospitalized older patients using a 
      computerized prescription support system (INTERcheck((R))).
PG  - 821-8
LID - 10.1007/s40266-013-0109-5 [doi]
AB  - BACKGROUND: Polypharmacy is very common among older adults and can lead to 
      inappropriate prescribing, poor adherence to treatment, adverse drug events and 
      the prevalence of potential drug-drug interactions (DDIs). Electronic 
      prescription database software may help to prevent inappropriate prescribing and 
      minimize the occurrence of adverse drug reactions. INTERcheck((R)) is a 
      Computerized Prescription Support System (CPSS) developed in order to optimize 
      drug prescription for elderly people with multimorbidity. OBJECTIVES: The 
      objectives of this study were (i) to evaluate the applicability of INTERcheck((R)) 
      as a means of reviewing the pharmacological profiles of elderly patients 
      hospitalized in an acute geriatric ward in Northern Italy; and (ii) to evaluate 
      the effectiveness of INTERcheck((R)) in reducing potentially inappropriate 
      medications (PIMs), potentially severe DDIs and the anticholinergic burden in 
      daily practice. METHODS: Two samples of elderly patients (aged 65+ years) 
      hospitalized in a geriatric ward in Italy were enrolled throughout 2012. During 
      the first (observation) phase, medications prescribed to 74 patients at admission 
      and discharge were analyzed with INTERCheck((R)) without any kind of interference 
      based on information obtained from the software. During the second (intervention) 
      phase, the treatment of 60 patients was reviewed and changed at discharge 
      according to INTERCheck((R)) suggestions. RESULTS: In the observational period, the 
      number of patients exposed to at least one PIM remained unchanged on both 
      admission (n = 29; 39.1 %) and discharge (n = 28; 37.8 %). In the intervention 
      phase, 25 patients (41.7 %) were exposed to at least one PIM at admission and 7 
      (11.6 %) at discharge (p < 0.001). The number of patients exposed to at least one 
      potentially severe DDI decreased from 27 (45.0 %) to 20 (33.3 %), although the 
      difference was not statistically significant (p = 0.703), while the number of 
      new-onset potentially severe DDIs decreased from 37 (59.0 %) to 9 (33.0 %) [p < 
      0.001]. CONCLUSIONS: The use of INTERCheck((R)) was associated with a significant 
      reduction in PIMs and new-onset potentially severe DDIs. CPSSs combining 
      different prescribing quality measures should be considered as an important 
      strategy for optimizing medication prescription for elderly patients.
FAU - Ghibelli, Simona
AU  - Ghibelli S
AD  - Geriatric Unit, Spedali Civili, Department of Clinical and Experimental Sciences, 
      University of Brescia, Brescia, Italy.
FAU - Marengoni, Alessandra
AU  - Marengoni A
FAU - Djade, Codjo D
AU  - Djade CD
FAU - Nobili, Alessandro
AU  - Nobili A
FAU - Tettamanti, Mauro
AU  - Tettamanti M
FAU - Franchi, Carlotta
AU  - Franchi C
FAU - Caccia, Silvio
AU  - Caccia S
FAU - Giovarruscio, Flavio
AU  - Giovarruscio F
FAU - Remuzzi, Andrea
AU  - Remuzzi A
FAU - Pasina, Luca
AU  - Pasina L
LA  - eng
PT  - Journal Article
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
RN  - 0 (Cholinergic Antagonists)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cholinergic Antagonists/pharmacology
MH  - Drug Interactions
MH  - Drug Therapy, Computer-Assisted/*methods
MH  - Female
MH  - Geriatrics
MH  - *Hospitalization
MH  - Humans
MH  - Inappropriate Prescribing/*prevention & control
MH  - Male
EDAT- 2013/08/15 06:00
MHDA- 2014/07/11 06:00
CRDT- 2013/08/15 06:00
PHST- 2013/08/15 06:00 [entrez]
PHST- 2013/08/15 06:00 [pubmed]
PHST- 2014/07/11 06:00 [medline]
AID - 10.1007/s40266-013-0109-5 [doi]
PST - ppublish
SO  - Drugs Aging. 2013 Oct;30(10):821-8. doi: 10.1007/s40266-013-0109-5.