Publication: Effect of a computerized decision support system on potentially inappropriate medication prescriptions for elderly patients in Thailand
19
Issued Date
2019-01-01
Resource Type
ISSN
13652753
13561294
13561294
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2-s2.0-85057456550
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Evaluation in Clinical Practice. Vol.25, No.3 (2019), 514-520
Suggested Citation
Vanida Prasert, Aiko Shono, Farsai Chanjaruporn, Chanuttha Ploylearmsang, Keerataphan Boonnan, Apinan Khampetdee, Manabu Akazawa Effect of a computerized decision support system on potentially inappropriate medication prescriptions for elderly patients in Thailand. Journal of Evaluation in Clinical Practice. Vol.25, No.3 (2019), 514-520. doi:10.1111/jep.13065 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/52357
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Title
Effect of a computerized decision support system on potentially inappropriate medication prescriptions for elderly patients in Thailand
Abstract
© 2018 John Wiley & Sons, Ltd. Rationale, aims, and objectives: The prescription of potentially inappropriate medication (PIM) is a global issue associated with increased adverse drug events, mortality, and health care expenditure. Computerized decision support system (CDSS) for the detection of PIM is a novel alert system in Thailand for reducing PIM prescriptions. The aim of this study was to evaluate the effect of a CDSS on PIM prescriptions for elderly patients in Thai community hospitals. Methods: The study design comprised two phases with a duration of 12 months each: pre-CDSS implementation (October 2015-March 2016) and post-CDSS implementation (October 2016-March 2017). Medical services and prescription claims data from four hospitals were used to calculate the prevalence of PIM prescriptions among elderly patients aged 60 years and older. Chi-square tests were used to analyse changes in PIM prescriptions across hospitals post CDSS. Results: The overall prevalence of PIM prescriptions post-CDSS implementation significantly decreased from 87.7% to 74.4%. The severity of mild and moderate PIMs was significantly reduced from 71.9% to 49.0% and from 64.5% to 48.7%, respectively. All hospitals had only one severe PIM, which was hyoscine. It was reduced from 4.7% to 1.5%, but the change was not significant (P = 0.74). The proportion of frequently prescribed PIMs in all PIM levels was significantly decreased, regardless of existing alternative medications. Conclusions: Specific CDSS for PIM in community hospital setting was associated with a reduction of PIM prescription in elderly patients. This CDSS can change physician's prescription behaviour to avoid inappropriate medications.