title: Electronic prescribing and other forms of technology to reduce inappropriate medication use and polypharmacy in older people: a review of current evidence.
abstract: This review provided an overview of the current evidence in relation to the use of e-prescribing and other forms of technology, such as CDSS, to reduce inappropriate prescribing in older people. The evidence indicates that various types of e-prescribing and CDSS interventions have the potential to reduce inappropriate prescribing and polypharmacy in older people, but the magnitude of their effect varies according to study design and setting. There was significant heterogeneity in the studies reported in terms of study designs, intervention design, patient settings, and outcome measures with patient outcomes seldom reported. Widespread diffusion of these interventions has not occurred in any of the health care settings examined. Overall, health care providers report being satisfied with e-prescribing systems and see the systems as having a positive impact on the safety of their prescribing practices, yet the problem of overriding or ignoring alerts persists. The problem of large numbers of inaccurate and insignificant alerts and this issue, along with the other barriers that have been identified, warrant further investigation.
authors.affiliation: HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland (RCSI), Division of Population Health Science, Beaux Lane House, Lower Mercer Street, Dublin 2, Ireland. barbaraclyne@rcsi.ie
authors.forename: Barbara
authors.initials: B
authors.lastname: Clyne
authors.forename: Marie C
authors.initials: MC
authors.lastname: Bradley
authors.forename: Carmel
authors.initials: C
authors.lastname: Hughes
authors.forename: Tom
authors.initials: T
authors.lastname: Fahey
authors.forename: Kate L
authors.initials: KL
authors.lastname: Lapane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016303:Clinical Pharmacy Information Systems; D020000:Decision Support Systems, Clinical; D011307:Drug Prescriptions / Q000592:standards; D017723:Drug Utilization Review / Q000458:organization & administration; D055695:Electronic Prescribing; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D016032:Randomized Controlled Trials as Topic