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An Electronic System to Document Reasons for Medication Discontinuation and to Flag Unwanted Represcriptions in Geriatric Patients

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Abstract

Background

Earlier studies have shown poor documentation of the reasons for medication discontinuation during hospitalization. Communication of reasons for discontinuation, e.g. adverse drug reactions (ADRs), to general practitioners and pharmacists was also found to be insufficient, leading to a rate of represcription after an ADR of 27 % during the first 6 months after discharge.

Objective

The aim of this study was to develop and implement a user-friendly electronic clinical decision support system to document reasons for medication discontinuation in hospitalized geriatric patients and to flag potentially undesirable represcriptions.

Methods

The electronic clinical decision support module was developed using the Gaston framework. Pop-up windows force physicians to document reasons for medication discontinuation, and the system alerts physicians to the represcription of drugs withdrawn because of an ADR. We interviewed users regarding the acceptability of the system.

Results

On a 20-bed geriatric ward, the electronic system documented 2,228 medication discontinuations and the reasons for them over 11.4 months and alerted physicians to represcription of drugs associated with an ADR 20 times. The system was considered to be user-friendly.

Conclusions

This clinical decision support system fulfilled its aims of documenting the reasons for medication discontinuation and alerting physicians to potentially undesirable represcription of previously withdrawn drugs. It was found to be user-friendly.

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Acknowledgments

C.M.J. van der Linden was financially supported by Catharina Hospital’s Science Fund. Catharina Hospital’s Science Fund had no role in any of the following: design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review or approval of the manuscript. The Methods section was revised by Paul A. de Clercq, Medecs.

Conflicts of Interest

All authors declare that they have no conflicts of interest, including specific financial interests and relationships and affiliations, relevant to the subject matter or materials discussed in the article.

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Authors and Affiliations

  1. Catharina Hospital, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands

    Carolien M. J. van der Linden, René J. E. Grouls & Erik H. M. Korsten

  2. Department of Geriatrics, University Medical Centre Utrecht, Utrecht, The Netherlands

    Paul A. F. Jansen

  3. EPHOR Expertise Centre Pharmacotherapy in Old Persons, Utrecht, The Netherlands

    Paul A. F. Jansen

  4. Department of Geriatrics, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands

    Rob J. van Marum

  5. Utrecht Institute for Pharmaceutical Sciences Utrecht, Utrecht, The Netherlands

    Toine C. G. Egberts

  6. University Medical Centre Utrecht, Utrecht, The Netherlands

    Toine C. G. Egberts

  7. Eindhoven University of Technology, Eindhoven, The Netherlands

    Erik H. M. Korsten

Authors
  1. Carolien M. J. van der Linden
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  2. Paul A. F. Jansen
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  3. Rob J. van Marum
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  4. René J. E. Grouls
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  5. Toine C. G. Egberts
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  6. Erik H. M. Korsten
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Corresponding author

Correspondence to Carolien M. J. van der Linden.

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van der Linden, C.M.J., Jansen, P.A.F., van Marum, R.J. et al. An Electronic System to Document Reasons for Medication Discontinuation and to Flag Unwanted Represcriptions in Geriatric Patients. Drugs Aging 29, 957–962 (2012). https://doi.org/10.1007/s40266-012-0035-y

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  • DOI: https://doi.org/10.1007/s40266-012-0035-y

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