| Titre : | Improving prescribing patterns for the elderly through an online drug utilization review intervention : A system linking the physician, pharmacist, and computer. (1998) |
| Auteurs : | M. MONANE ; M.A. KELLY ; D.M. MATTHIAS ; B.A. NAGLE ; Departments of Medical Affairs. Merck-Medco Managed Care. Llc. Montvale NJ. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (n° 14, 1998) |
| Pagination : | 1249-1252 |
| Langues: | Anglais |
| Mots-clés : | Grand âge ; Homme ; Pharmacologie ; Qualité ; Responsabilité professionnelle ; Pharmacien ; Médecin ; Efficacité ; Evaluation ; Informatique |
| Résumé : | [BDSP. Notice produite par INIST 0jAR0x9O. Diffusion soumise à autorisation]. Context. - Pharmacotherapy is among the most powerful interventions to improve health outcomes in the elderly. However, since some medications are less appropriate for older patients, systems approaches to improving pharmacy care may be an effective way to reduce inappropriate medication use. Objective. - To determine whether a computerized drug utilization review (DUR) database linked to a telepharmacy intervention can improve suboptimal medication use in the elderly. Design. - Population-based cohort design, April 1,1996, through March 31,1997. Setting. - Ambulatory care. Patients. - A total of 23 269 patients aged 65 years and older throughout the United States receiving prescription drug benefits from a large pharmaceutical benefits manager during a 12-month period. Intervention. - Evaluation of provider prescribing through a computerized online DUR database using explicit criteria to identify potentially inappropriate drug use in the elderly. Computer alerts triggered telephone calls to physicians by pharmacists with training in geriatrics, whereby principles of geriatric pharmacology were discussed along with therapeutic substitution options. Main Outcome Measures. - Contact rate with physicians and change rate to suggested drug regimen. Results. - A total of 43007 alerts were triggered. From a total of 43007 telepharmacy calls generated by the alerts, we were able to reach 19368 physicians regarding 24266 alerts (56%). (...) |
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