Exploring the utility of automated drug alerts in home healthcare.
Computerized drug utilization review (DUR) can potentially reduce adverse drug events. We examined automated DUR for home healthcare patients with diabetes or hypertension. Sixty-eight percent of diabetes patients and 50.7% of hypertension patients triggered severe, moderate, or duplicative alerts. Among diabetes patients, 74.3% of duplicative alerts were trivial or inappropriate, compared with 3.9% among hypertension patients. Experts judged that 40.5% of high-risk diabetes patients and 53.6% of hypertension patients had alerts requiring nurse follow-up. Adequate follow-up was significantly lower for the former. The relationship between inappropriate alerts and poorer follow-up reinforces the need for more specific alert systems to focus clinicians' attention on clinically important alerts.
Feldman
Penny Hollander
PH
Center for Home Care Policy and Research, Visiting Nurse Service of New York, NY, USA. pfeldman@vnsny.org
McDonald
Margaret
M
Rosati
Robert J
RJ
Murtaugh
Christopher
C
Kovner
Christine
C
Goldberg
Judith D
JD
King
Lori
L