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Pharma & Clinical Pharmacy Congress 2016
November 07-09, 2016
Volume 5 Issue 4(Suppl) Clin Pharmacol Biopharm
ISSN: 2167-065X CPB, an open access journal
conferenceseries .com
November 07-09, 2016 Las Vegas, Nevada, USA
4th International
Pharma & Clinical Pharmacy Congress
Wan-O Chu et al., Clin Pharmacol Biopharm 2016, 5:4(Suppl)
Efficiency of computerized warning system reduces polypharmacy in the elderly
Wan-O Chu, Chia-Li Lee, Lih-Chi Chen, Li-Ying Huang and Sun-Wen Jung
Taipei City Hospital, Taiwan
Objective: Polypharmacy in the elderly complicates therapy, increases cost and is a challenge for healthcare agencies.
Computerized warning system to reduce polypharmacy is a drug optimization process.
Methods:We used a prospective before-and-after design among patients aged 80 years or older admitted to Taipei City Hospital
from November 1, 2012, through January 31, 2013 before the addition of the warning system and from April 1, 2014 through
June 30, 2014 after the warning system was added. We enrolled 189 elderly adults (aged ≥80 years) who had been prescribed 10
or more chronic medications (drugs prescribed for ≥28 days), visited three or more different physician visits during 3 month
screening period before warning system setting. Data were analyzed using Pair t test and significance (α) was set at P<0.05 by
the JMP5.12.
Results: We enrolled 189 patients in our study, excluded 30 patients without physician visits after warning system setting,
where the ratio of males: females were 89:70. The mean (SD) age of our patients was 85.8 (10.2) years. After the warning
system was deployed, there was an immediate and sustained decrease in the rate of orders for the medications. The mean rate
of prescribing medications dropped from 14.1 to 11.4 orders per day (SD 2.7; P<0.001) and physician visits number decreased
from 3.5 to 3.1 per month (SD 0.5; P<0.001). There was no evidence that this effect waned over time.
Conclusions: Computerized warning system embedded into the healthcare information system (HIS), used in patients,
can decrease the medication number quickly and specifically. The financial cost of polypharmacy involves both the direct
expenditures for prescription medications as well as significant indirect costs related to hospitalization and treatment of severe
adverse drug reactions. Computerized warning system may have a positive impact on prescribers and patients. The mainstay
for preventing and managing polypharmacy remains heightened awareness of patients at risk. Pharmacovigilance is required
by the patient, physician and pharmacist in thoroughly reviewing and reconciling the patient's medication regimen at every
opportunity.
Biography
Wan-O Chu has graduated from the Department of Pharmacy Taipei Medical University (TMU) and Institute of Biomedical Engineering National Yang Ming
University. He is an Adjunct Instructor at TMU and a Pharmacist in Taipei City Hospital, Department of Pharmacy. He has published more than 10 papers in a local
journal and 2 posters in International Pharmaceutical Federation (FIP).