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digital.ahrq.gov/sites/default/files/docs/cds-medication-management-slides-012814.pdf
January 28, 2014 - Simon
VA Boston Healthcare System
Background
• Medication monitoring
► Many medications require … prescribeda,b 3.4 (1.5) 3.2 (1.5)
Number of medications prescribed
on encounter date of interestb … and
79.4% of medications in intervention
practices. … Key Findings Summary
• During the intervention, complete
monitoring occurred for 62.4% of
medications … • For medications requiring three or more
laboratory tests, at most 17.7% had
evidence of complete
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digital.ahrq.gov/ahrq-funded-projects/using-health-information-technology-improve-ambulatory-chronic-disease-care/annual-summary/2010
January 01, 2010 - Web-based, interactive software system that features secure messaging, in-home reconciliation of all medications … screens allow the clinician to view multiple elements of a patient record, such as laboratory values and medications … This message did not include an all-inclusive list of patient medications, only the changes patients … evaluated the information the patient sent, the nature of problems identified (e.g., incorrect listing of medications
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digital.ahrq.gov/ahrq-funded-projects/hit-based-regional-medication-management-pharmacy-system/annual-summary/2009
January 01, 2009 - in remote, sparsely populated areas can improve the effectiveness of caregivers and the safe use of medications … The codes were reviewed to determine when and why nursing staff were retrieving newly-ordered medications … It is difficult to predict how many of the ordered medications would have actually been administered … had the hub hospital pharmacist not intervened, or the number of resultant patient injuries had these medications
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digital.ahrq.gov/ahrq-funded-projects/electronic-prescribing-and-decision-support-improve-rural-primary-care-quality/annual-summary/2010
January 01, 2010 - Hypertension, Rural Health *
Summary: For many chronic conditions, poor patient compliance with prescribed medications … software (DrFirst Rcopia) that provides physicians the capability to track the fill status of prescribed medications … Specific Aims:
Improve the rate of adherence to prescribed medications among patients with hypertension … in rural communities. ( Ongoing )
Improve adherence to prescribed medications among patients with
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digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/rose-af-et-al-2005
January 01, 2005 - Users of this feature can quickly glance at a selected patient's problems, medications, visits, notes … quick to point out that its layout feels cluttered in the 800 · 600 display and the Notes, Visits, and Medications … "[M]ost of the task analysis participants said they would not need to invoke Popup to access the Medications … particular workflow required frequent access to other modules of the [EMR], most notably Patient Summary, Medications
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs024004-bajaj-final-report-2017.pdf
January 01, 2017 - ,
missing or increasing dose
New medications and
supplements
Enter new medicine and
dose … Entry into the App: Patients and caregivers were able to monitor the adherence to all
medications … , critical medications as well as daily weight (Figures 2 A-C). … Fig 2A: Adherence on all medications averaged over the study duration. … Each column
represents the average adherence on all medications for one individual patient followed
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digital.ahrq.gov/sites/default/files/docs/citation/r36hs021976-gatwood-final-report-2014.pdf
January 01, 2014 - While numerous treatment options exist
to treat diabetes, adherence to these medications remains … At study endpoint, subjects were
again asked to list their current medications and respond to the … The majority of subjects (70%) reported taking one or two medications each day at an
average of four … A negative relationship between the
number of medications and perceived barriers (r = -0.42, p=0.004 … At baseline, adherence to diabetes medications was relatively
high in the active and control arms,
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017010-bailey-final-report-2011.pdf
January 01, 2011 - Many medications have not been evaluated for safety in
pediatric use and are routinely prescribed off … However,
greater knowledge and better medications to modify the side effects of antineoplastics have … Of these
approximately 300 are receiving active treatment, and receive a wide variety of medications … An important element of their methodology was the
establishment of associations between medications … They also recorded the responsible
medications, and a narrative of the event.
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digital.ahrq.gov/sites/default/files/docs/citation/r18hs017201-simon-final-report-2012.pdf
January 01, 2012 - Data on medications,
laboratory tests, and patient portal use were collected through the EHR vendor … Many medications require laboratory measurement at initial prescription and during ongoing
monitoring … Additionally, the
moderator shared with FGD participants a list of proposed medications that generated … To design the alerts, we first derived a starter list of medications requiring laboratory testing at … In addition, this table presents the prioritization of the medications so as to
prevent duplication
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs022336-farris-final-report-2017.pdf
January 01, 2017 - Studies suggest that 33-50% of patients do not take
medications properly, costing about $290 billion … The focus of this proposal is medication adherence because patients’
failure to take their medications … Studies suggest that 33-50% of patients do not take their medications
properly, contributing to nearly … For example, in a one-year study of ~5,000 hypertensive patients, most patients took
their medications … only intermittently with half of patients eventually discontinuing their medications
against medical
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs024335-rangachari-final-report-2018.pdf
January 01, 2018 - The process of MedRec comprises several key steps: (1)
develop a list of the patient’s current medications … ; (2) develop a list of the medications to be prescribed; (3)
compare the medications on the two lists … This challenge in turn, was ascribed to the general
reluctance of physicians to discontinue medications … In other words, doing
something to reconcile medications (using External Rx Import), is better than … in each quarter; and all patients with reported active medications (Group 4) in
each quarter, over
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digital.ahrq.gov/sites/default/files/docs/publication/u18hs016970-bates-final-report-2012.pdf
January 01, 2012 - are affecting
them and what medications they are actually taking. … If a patient was prescribed more than one of the target medications during a visit, one
medication was … We performed an
analysis of symptoms reported by patients taking one of these medications compared to … Any
discrepancies in dosage, frequency, missing medications, or additional medications were noted and … The most common inaccuracy was documentation of medications the patient was no longer
prescribed.
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digital.ahrq.gov/ahrq-funded-projects/visualdecisionlinc-real-time-decision-support-behavioral-health/annual-summary/2011
January 01, 2011 - The SSAs include demographics such as race, gender, and age; comorbid conditions; and prescribed medications … At the UI level, the prescribed medications were organized by medication class to facilitate the understanding … conditions for the comparative population as well as an overview of the patient's medical profile, including medications
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digital.ahrq.gov/ahrq-funded-projects/using-health-information-technology-improve-transitions-complex-elderly/annual-summary/2011
January 01, 2011 - transitions, including the rate of followup office visits, the rate of appropriate monitoring for high-risk medications … impact of automated monitoring alerts on the rate of appropriate monitoring for selected high-risk medications … baseline results, including a manuscript, Baseline and follow-up laboratory monitoring of cardiovascular medications
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digital.ahrq.gov/sites/default/files/docs/publication/u19hs021094-bates-final-report-2017.pdf
January 01, 2017 - We also measured total #’s
and percentage of medications stopped for adverse effects vs. controls for … We identified 11,128 patients newly started on the target medications whom we cluster
randomized into … Three quarters of clinician
notes refer to one or more medications, with 34% of these being a new or … Given the
large numbers of medications initiated, manual monitoring efforts such as patient outreach … An additional study outcome metric is total target medications for discontinuation with
reason being
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs018648-atlas-final-report-2014.pdf
January 01, 2014 - The analytic cohort of patients consisted of those
individuals who were prescribed medications used … When one of these study medications was prescribed, the intervention
physician had the opportunity … Prescribed study medications by participating PCPs were
obtained from the EHR. … Over the 12-‐month study period, 3022 eligible study
medications were prescribed for 2049 patients … However, similar
results were not seen for HbA1c control among oral medications used to manage type
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digital.ahrq.gov/ahrq-funded-projects/assessment-pediatric-look-alike-sound-alike-lasa-substitution-errors/annual-summary/2010
January 01, 2010 - This study will identify pediatric medications that are at highest risk of causing child harm through … screening alerts. ( Ongoing )
2010 Activities: The project began by identifying the LASA list of medications … Beginning with 17,000 medications, the team eliminated LASA pairs where one of the drugs in the pair
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs019023-mane-final-report-2014.pdf
January 01, 2014 - to MDD like – mood disorder,
anxiety disorder, substance use disorder, and others); and prescribed medications … Thirteen distinct medication classes were
identified, and all individual medications were classified … predictive data
attributes included demographic information, comorbidities, past medical history, medications … ;
medications prescribed to a similar (or comparative) patient population; and predicted outcome … Modifications
were made to tightly integrate medications with the timeline view.
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digital.ahrq.gov/sites/default/files/docs/publication/r21hs022166-beebe-final-report-2016.pdf
January 01, 2016 - For purposes of this project and based upon the medications most commonly
prescribed to participants … all sure = 1; somewhat sure = 2; or very sure = 3) that they will be able to adhere
to prescribed medications … was collected at baseline and data on
living arrangements and prescribed medications was updated … Pill counts scores for
psychiatric medications for experimental participants averaged 67.4% (SD27.1 … Further, some psychiatric medications (e.g.
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digital.ahrq.gov/sites/default/files/docs/citation/r01hs023694-schiff-final-report-2018.pdf
January 01, 2018 - Usability Metrics/Analysis
We recorded the medications ordered with each task and calculated an error … (itching) to represent three
distinct types of medications: daily medications (gout), sensitive issues … Figure 2: Indications prototype screenshot of recommended medications based on indication of migraine … medications or situations
where the diagnosis is uncertain. … Development and evaluation of an ensemble resource linking
medications to their indications.