A new clinical decision support (CDS) intervention tool developed by the Houston Methodist Hospital system was found to be effective in reducing potentially inappropriate medication use in older patients.
After years of attempting to reduce exposure of potentially inappropriate medications through other methods, the hospital system developed a new strategy designed to lessen the burden for providers and pharmacists. Using data from American Geriatric Society Beers Criteria and internal data, a passive CDS approach termed “geriatric context” was developed by the health system to recommend appropriate medication selection including lower dosage amounts and frequency of administration in older adults.
Houston Methodist researchers studied changes in a pre- and post-implementation analysis of medication usage patterns for two nine-month time periods in 2019 and 2021 in patients age 65 and older across the eight-hospital health system. A total of 62,738 older adult hospital admissions were included in the study.
The hospital system reported significant reductions in the prescribing of potentially inappropriate medications using the CDS intervention tool. The antipsychotic medicine Haloperidol showed the greatest reduction in inappropriate doses from 41.5% to 21.4% of orders, followed by reduction in inappropriate frequencies in orders for diphenhydramine, an antihistamine drug, from 57.2% to 39.7%, researchers found.
There were also favorable reductions in total daily dosage and average dose per patient among 11 of the 16 medications that were administered.
“Utilization of a passive CDS positively influences prescribing patterns for older adults and reduces the alert burden to ordering providers,” the researchers concluded.
The study’s findings were published Sept. 14 in the Journal of the American Geriatrics Society.
