An Electronic Medical Record (EMR)-Based Intervention to Reduce Polypharmacy and Falls in an Ambulatory Rural Elderly Population

Background Falls are the leading cause of injury-related deaths in the aging population. Electronic medical record (EMR) systems can identify at-risk patients and enable interventions to decrease risk factors for falls. Objective The objectives of this study were to evaluate an EMR-based interventio...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2008-04, Vol.23 (4), p.399-404
Main Authors: Weber, Valerie, White, Alan, McIlvried, Robb
Format: Article
Language:English
Subjects:
Accidental Falls - prevention & control
Aged
Attitude to Computers
Case-Control Studies
Cohort Studies
Decision Support Systems, Clinical
Drug use
Electronic health records
Falls
Female
Health Services for the Aged
Humans
Internal Medicine
Male
Medical Audit
Medical Records Systems, Computerized
Medicine
Medicine & Public Health
Older people
Original
Original Article
Outpatient Clinics, Hospital
Pennsylvania
Physicians, Family
Polypharmacy
Practice Patterns, Physicians
Prevention programs
Psychotropic Drugs - adverse effects
Reminder Systems
Risk Factors
Rural health care
Rural Population
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Summary:Background Falls are the leading cause of injury-related deaths in the aging population. Electronic medical record (EMR) systems can identify at-risk patients and enable interventions to decrease risk factors for falls. Objective The objectives of this study were to evaluate an EMR-based intervention to reduce overall medication use, psychoactive medication use, and occurrence of falls in an ambulatory elderly population at risk for falls. Design Prospective, randomized by clinic site. Patients/Participants Six-hundred twenty community-dwelling patients over 70 at risk for falls based on age and medication use. Interventions A standardized medication review was conducted and recommendations made to the primary physician via the EMR. Measurements and Main Results Patients were contacted to obtain self reports of falls at 3-month intervals over the 15-month period of study. Fall-related diagnoses and medication data were collected through the EMR. A combination of descriptive analyses and multivariate regression models were used to evaluate differences between the 2 groups, adjusting for baseline medication patterns and comorbidities. Although the intervention did not reduce the total number of medications, there was a significant negative relationship between the intervention and the total number of medications started during the intervention period ( p  
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-007-0482-z