Skip to main content
Erschienen in: Zeitschrift für Gerontologie und Geriatrie 3/2016

01.04.2016 | Original contribution

Prescription errors in geriatric patients can be avoided by means of a computerized physician order entry (CPOE)

verfasst von: S. Frisse, G. Röhrig, MD, MPH, J. Franklin, M.C. Polidori, R.-J. Schulz

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

The implementation of a computerized physician order entry (CPOE) can help reduce prescription errors in clinical practice.

Objective

The aim of this study was to evaluate the effects of a CPOE for geriatric patients with the two most common conditions for drug-induced iatrogenic diseases, dysphagia and renal failure.

Subjects and methods

A retrospective analysis of actual drug prescriptions versus CPOE recommendations in the geriatric department of the St. Marien Hospital in Cologne, Germany was carried out. Actual drug prescriptions were collected for 26 patients with dysphagia (15 female, 11 male, average age 82.3 ± 8.0 years) and 35 patients with renal failure (23 female, 12 male, average age 80.5 ± 6.7 years) which were compared with recommended prescriptions by means of a CPOE and discrepancies were statistically analyzed.

Results

Prescription errors for at least 1 drug were detected in 46 % of patients with renal failure and the administration of at least 1 drug with inadequate crushing was observed in 77 % of dysphagia patients.

Conclusion

Prescription errors appear to be frequent to highly frequent in the medical routine even in a highly specialized geriatric setting. Inaccuracies might be reduced by the implementation of a CPOE and even more if coupled to a decision support system. Drug-drug or drug-disease interactions, which are particularly high risks in patients with multimorbidities, multidrug therapy, renal failure or malnutrition, might be kept under control through careful verification of medication indications, organ function status as well as drug administration and preparation in cases of tube feeding.
Literatur
1.
Zurück zum Zitat Amann U, Schmedt N, Garbe E (2012) Prescribing of potentially inappropriate medications for the elderly: an analysis based on the PRISCUS list. Dtsch Arztebl Int 109(5):69–75PubMedPubMedCentral Amann U, Schmedt N, Garbe E (2012) Prescribing of potentially inappropriate medications for the elderly: an analysis based on the PRISCUS list. Dtsch Arztebl Int 109(5):69–75PubMedPubMedCentral
2.
Zurück zum Zitat Aras S, Varli M, Uzun B, Atli T, Keven K, Turgay M (2012) Comparison of different glomerular filtration methods in the elderly: which formula provides better estimates? Ren Fail 34(4):435–41CrossRefPubMed Aras S, Varli M, Uzun B, Atli T, Keven K, Turgay M (2012) Comparison of different glomerular filtration methods in the elderly: which formula provides better estimates? Ren Fail 34(4):435–41CrossRefPubMed
3.
Zurück zum Zitat Budnitz DS, Lovegrove MC, Shehab N, Richards CL (2011) Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med 365:2002–2012CrossRefPubMed Budnitz DS, Lovegrove MC, Shehab N, Richards CL (2011) Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med 365:2002–2012CrossRefPubMed
4.
Zurück zum Zitat Cockroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41CrossRef Cockroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41CrossRef
5.
Zurück zum Zitat Daniels SK, Brailey K, Priestly DH, Herrington LR, Weisberg LA, Foundas AL (1998) Aspiration in patients with acute stroke. Arch Phys Med Rehabil 79(1):14–19CrossRefPubMed Daniels SK, Brailey K, Priestly DH, Herrington LR, Weisberg LA, Foundas AL (1998) Aspiration in patients with acute stroke. Arch Phys Med Rehabil 79(1):14–19CrossRefPubMed
7.
Zurück zum Zitat Gallagher P, O`Mahony D (2008) STOPP (Screening Tool of Older Persons’potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria. Age Ageing 37:673–679CrossRefPubMed Gallagher P, O`Mahony D (2008) STOPP (Screening Tool of Older Persons’potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria. Age Ageing 37:673–679CrossRefPubMed
8.
Zurück zum Zitat Holt S, Schmiedl S, Thürmann PA (2010) Potentially inappropriate medications in the elderly: the PRISCUS List. Dtsch Arztebl Int 107(31–32):543–551PubMedPubMedCentral Holt S, Schmiedl S, Thürmann PA (2010) Potentially inappropriate medications in the elderly: the PRISCUS List. Dtsch Arztebl Int 107(31–32):543–551PubMedPubMedCentral
9.
Zurück zum Zitat Kelly J, Wright D, Wood J (2011) Medicine administration errors in patients with dysphagia in secondary care: a multi-centre observational study. J Adv Nurs 67 (12):2615–2627CrossRefPubMed Kelly J, Wright D, Wood J (2011) Medicine administration errors in patients with dysphagia in secondary care: a multi-centre observational study. J Adv Nurs 67 (12):2615–2627CrossRefPubMed
10.
Zurück zum Zitat Long CL, Raebel MA, Price DW, Magid DJ (2004) Compliance with dosing guidelines in patients with chronic kidney disease. Ann Pharmacother 38:853–858CrossRefPubMed Long CL, Raebel MA, Price DW, Magid DJ (2004) Compliance with dosing guidelines in patients with chronic kidney disease. Ann Pharmacother 38:853–858CrossRefPubMed
11.
Zurück zum Zitat Papaioannou A, Clarke JA, Campbell G, Bedard M (2000) Assessment of adherence to renal dosing guidelines in long-term care facilities. J Am Geriatr Soc 48:1470–1473CrossRefPubMed Papaioannou A, Clarke JA, Campbell G, Bedard M (2000) Assessment of adherence to renal dosing guidelines in long-term care facilities. J Am Geriatr Soc 48:1470–1473CrossRefPubMed
14.
Zurück zum Zitat Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park BK, Breckenridge AM (2004) Adverse drug reactions as cause of admission to hospital: Prospective analysis of 18820 patients. BMJ 329:15–19CrossRefPubMedPubMedCentral Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park BK, Breckenridge AM (2004) Adverse drug reactions as cause of admission to hospital: Prospective analysis of 18820 patients. BMJ 329:15–19CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Pretorius RW, Gataric G, Swedlund SK, Miller JR (2013) Reducing the risk of adverse drug events in older adults. Am Fam Physician 87(5):331–336PubMed Pretorius RW, Gataric G, Swedlund SK, Miller JR (2013) Reducing the risk of adverse drug events in older adults. Am Fam Physician 87(5):331–336PubMed
16.
Zurück zum Zitat Roberts GW, Ibsen PM, Schiøler CT (2009) Modified diet in renal disease method overestimates renal function in selected elderly patients. Age Ageing 38:698–703CrossRefPubMed Roberts GW, Ibsen PM, Schiøler CT (2009) Modified diet in renal disease method overestimates renal function in selected elderly patients. Age Ageing 38:698–703CrossRefPubMed
17.
Zurück zum Zitat Rochon PA, Field TS, Bates DW, Lee M, Gavendo L, Erramuspe-Mainard J, Judge J, Gurwitz JH (2005) Computerized physician order entry with clinical decision support in the long-term care setting: insights from the Baycrest Centre for Geriatric Care. J Am Geriatr Soc 53:1780–1789CrossRefPubMed Rochon PA, Field TS, Bates DW, Lee M, Gavendo L, Erramuspe-Mainard J, Judge J, Gurwitz JH (2005) Computerized physician order entry with clinical decision support in the long-term care setting: insights from the Baycrest Centre for Geriatric Care. J Am Geriatr Soc 53:1780–1789CrossRefPubMed
18.
Zurück zum Zitat Salomon L, Deray G, Jaudon MC, Chebassier C, Bossi P, Launay-Vacher V, Diquet B, Ceza JM, Levu S, Bruecker G, Ravaud P (2003) Medication misuse in hospitalized patients with renal impairment. Int J Qual Health Care 15(4):331–335CrossRefPubMed Salomon L, Deray G, Jaudon MC, Chebassier C, Bossi P, Launay-Vacher V, Diquet B, Ceza JM, Levu S, Bruecker G, Ravaud P (2003) Medication misuse in hospitalized patients with renal impairment. Int J Qual Health Care 15(4):331–335CrossRefPubMed
19.
Zurück zum Zitat Simon SR, Keohane CA, Amato M, Coffey M, Cadet B, Zimlichman E, Bates DW (2013) Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study. BMC Med Inform DecisMak 13:67CrossRef Simon SR, Keohane CA, Amato M, Coffey M, Cadet B, Zimlichman E, Bates DW (2013) Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study. BMC Med Inform DecisMak 13:67CrossRef
20.
Zurück zum Zitat SPSS Inc (2008) SPSS Statistics for Windows, Version 17.0. Chicago SPSS Inc (2008) SPSS Statistics for Windows, Version 17.0. Chicago
21.
Zurück zum Zitat Stuerzlinger H, Hiebinger C, Pertl D, Traurig P (2009) Computerized physician order entry—effectiveness and efficiency of electronic medication ordering with decision support systems. GMS Health Technol Assess 86(1):2 Stuerzlinger H, Hiebinger C, Pertl D, Traurig P (2009) Computerized physician order entry—effectiveness and efficiency of electronic medication ordering with decision support systems. GMS Health Technol Assess 86(1):2
22.
Zurück zum Zitat Syed S, Wang D, Goulard D, Rich T, Innes G, Lang E (2013) Computer order entry systems in the emergency department significantly reduce the time to medication delivery for high acuity patients. Int J Emerg Med 6(1):20CrossRefPubMedPubMedCentral Syed S, Wang D, Goulard D, Rich T, Innes G, Lang E (2013) Computer order entry systems in the emergency department significantly reduce the time to medication delivery for high acuity patients. Int J Emerg Med 6(1):20CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Terrell KM, Perkins AJ, Hui SL, Callahan CM, Dexter PR, Miller DK (2010) Computerized decision support for medication dosing in renal insufficiency: a randomized, controlled trial. Ann Emerg Med 56:623–629CrossRefPubMed Terrell KM, Perkins AJ, Hui SL, Callahan CM, Dexter PR, Miller DK (2010) Computerized decision support for medication dosing in renal insufficiency: a randomized, controlled trial. Ann Emerg Med 56:623–629CrossRefPubMed
24.
Zurück zum Zitat Tosato M, Landi F, Martone AM, Cherubini A, Corsonello A, Volpato S, Bernabei R, Onder G (2014) Potentially inappropriate drug use among hospitalised older adults: results from the CRIME study. Age Ageing 43(6):767–773CrossRefPubMed Tosato M, Landi F, Martone AM, Cherubini A, Corsonello A, Volpato S, Bernabei R, Onder G (2014) Potentially inappropriate drug use among hospitalised older adults: results from the CRIME study. Age Ageing 43(6):767–773CrossRefPubMed
Metadaten
Titel
Prescription errors in geriatric patients can be avoided by means of a computerized physician order entry (CPOE)
verfasst von
S. Frisse
G. Röhrig, MD, MPH
J. Franklin
M.C. Polidori
R.-J. Schulz
Publikationsdatum
01.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 3/2016
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-015-0911-2

Weitere Artikel der Ausgabe 3/2016

Zeitschrift für Gerontologie und Geriatrie 3/2016 Zur Ausgabe

Beiträge zum Themenschwerpunkt

„EduKation demenz®“

Beiträge zum Themenschwerpunkt

Admission into a Nursing Home

Beiträge zum Themenschwerpunkt

Familienbegleitung

Beiträge zum Themenschwerpunkt

Train the trainer in dementia care