Polypharmacy, the Electronic Medical Record, and Adverse Drug Events.

摘要

Polypharmacy, a concurrent chronic use of multiple prescribed and over-the-counter medications by the same individual, is one of the clinical problems facing primary care providers. Polypharmacy creates the potential for adverse drug-related events, especially in the elderly. The advent of electronic medical records (EMR) may help identify and respond to these potential adverse events. The purpose of this project was to investigate the relationship between the total number of medication taken by elderly, 65 years and older, and the severity of drug-drug and drug-disease interactions triggered by the EMR system. The study used a retrospective chart review of the EMRs. Three independent variables (age, gender, and number of medications) and 4 dependent variables (major drug-drug, moderate drug-drug, major drug-drug, and moderate drug-drug interactions) were analyzed among a sample of 247 individuals, ranging in age from 65 to 98 years. The total number of medications used among this sample ranged from 2 to 27 medications, with 177 (71.7%) patients using 2 to 9 medications, and 70 (28.3%) using 10 or more medications. Correlational analysis showed a positive relationship between number of medication and major drug-drug, moderate drug-drug, major drug-disease, and moderate drug-disease interactions (r = 0.240, p = 0.0001; r = .596, p = 0.0001; r = 464, p =0.0001; r = 669, p = 0.0001, respectively). However, there was no significant relationship between age and major and moderate drug-drug and drug disease interactions. The results of this study contribute to positive social change by increasing primary care providers' understanding of the EMR as a tool to improve the identification and management of patients with polypharmacy.