Medication reviews with computerised expert support: Evaluation of a method to improve the quality of drug utilisation in the elderly

Abstract

Purpose

This paper aims to examine whether a computerised system for medication reviews can support physicians' decisions and improve the quality of drug treatment in the elderly.

Design/methodology/approach

This is a descriptive intervention study. The study included 275 patients living in community settings and nursing homes in Stockholm, Sweden. Patient data were analysed using computer software and scrutinised by a clinical pharmacologist. Pharmaco‐therapeutic advice was sent to the physician responsible for each patient. The main outcome measures were initiation and discontinuation of drugs, changes of doses and rates of identified drug‐related problems.

Findings

Expert opinions were given by the clinical pharmacologist, for 275 patients, mean age 85 years; 70 per cent female. An average of 3.3 remarks was given concerning unsuitable drugs, unclear indication, dosing when the kidney function was decreased, drug‐drug interactions and quality indicators. On average 1.5 drug‐related problems (DRP) per patient were attended to by the responsible physician at each unit. The most common action taken was withdrawal of a drug (n=208). On average the drug use decreased from 10.4 to 9.5 drugs per patient, and several quality indicators were met. The drug costs decreased, and resulted in a more cost‐effective drug therapy.

Originality/value

The paper develops and tests a method for intervention in the care of elderly patients. The method is based on a computerised expert support system for medication reviews at a distance and on education of the staff. A safer drug therapy with improved quality and cost‐effectiveness is thus provided.

Citation

Ulfvarson, J., Bastholm Rahmner, P., Fastbom, J., Sjöviker, S. and Andersén Karlsson, E. (2010), "Medication reviews with computerised expert support: Evaluation of a method to improve the quality of drug utilisation in the elderly", International Journal of Health Care Quality Assurance, Vol. 23 No. 6, pp. 571-582. https://doi.org/10.1108/09526861011060933