PIC
|
New Mexico Prescription Improvement Coalition |
|
|
|
|
A monthly publication on prescription improvement in New Mexico Vol. 6, Issue 6 | June 2011 |
| National News: Health Information Technology |
| AHRQ Examines IT’s Impact on Drug Management
Authors of a report published online by the Agency for Healthcare Research and Quality and based on a review of professional literature from 428 articles have concluded that the role of health information technology in medication management is well-studied and “holds the promise of improved processes,” but “clinical and economics studies and the understanding of sustainability issues are lacking.” For example, as many as 174 studies reviewed by researchers addressed the role of e-prescribing in medication management, particularly IT systems for clinical decision support and computerized physician order entry in hospitals and in ambulatory care. They indicate there is substantial evidence that “care processes such as medication errors, time for tasks, workflow and knowledge, skills, and attitudes can be improved” with the use of technology, according to the report. Read more View full report Federal HIT Incentives Helped Grow E-Prescribing by 72 Percent in 2010 Surescripts recently released “The National Progress Report on E-Prescribing and Interoperable Healthcare” for 2010, the fourth in an annual series that tracks the status of e-prescribing adoption and use in the United States. This year’s report measures the growth of e-prescribing from 2008 – before the advent of federal incentives – through 2010 and includes new data that provides further detail on physician adoption of e-prescribing and electronic health records. The number of prescribers routing prescriptions electronically grew from 74,000 at the end of 2008 to 234,000 by the end of 2010 – representing 34 percent of all office-based prescribers and 36 percent of office-based physicians. The number of electronic prescriptions in 2010 grew to 326 million, up from 190 million e-prescriptions in 2009. By the end of 2010, approximately 25 percent of eligible prescriptions were prescribed electronically. ;Full story
|
| National News: Adverse Drug Events |
| Detecting Drug Interactions from Adverse-Event Reports: Interaction between Paroxetine and Pravastatin Increases Blood Glucose Levels
Clinical pharmacists may wish to review the following article: it might be interesting to see how many of your patients are on both of these medications and determine if they have hyperglycemia and/or diabetes. Authors: NP Tatonetti, JC Denny, SN Murphy, GH Fernald, G Krishnan, V Castro, P Yue, PS Tsau, I Kohane, DM Roden and RB Altman Abstract: Unexpected interactions between the lipid-lowering agent pravastatin and the antidepressant paroxetine could have important public health implications. The authors mined the U.S. Food and Drug Administration’s (FDA’s) Adverse Event Reporting System (AERS) for side-effect profiles involving glucose homeostasis and found a surprisingly strong signal for comedication with pravastatin and paroxetine. They found that pravastatin and paroxetine, when administered together, had a synergistic effect on blood glucose. The average increase was 19 mg/dl (1.0 mmol/l) overall, and in those with diabetes it was 48 mg/dl (2.7 mmol/l). Access article New Tool Predicts Adverse Drug Events in Elderly Patients According to a study published in the June 13 issue of the Archives of Internal Medicine, “A new set of criteria for identifying potentially hazardous medications in elderly patients accurately predicted serious adverse drug events.” Investigators evaluated 600 consecutive patients, over the age of 65, admitted for treatment of an acute illness and found that the chance of an avoidable adverse event occurring was significantly greater when medication use was evaluated with the criteria known as STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions). Read more Adverse Drug Events Result in 4.5M Doctor or Hospital Visits Yearly Patients taking more than six medications are the most likely to be among the millions of Americans who receive treatment each year due to adverse drug-related events, according to a report published online in Health Services Research. Monitoring patients’ medication lists can help, experts say, but patient education is also important. “From some of the work we’ve done in health literacy research, we know that nearly half of patients misunderstand common instructions,” said Michael Wolf, associate professor of medicine and learning sciences at Northwestern University Feinberg School of Medicine. Read more PDR Network has launched a national adverse drug event network to enable physicians to report such events via their electronic health record (EHR) system, or through a new Web site, RxEvent.org. Montvale, N.J.-based PDR Network distributes drug safety information, FDA-issued product safety alerts and other services such as the Physicians’ Desk Reference. The company in late 2010 also launched an EHR safety reporting website, EHRevent.org, where providers can report safety issues related to the use of EHRs. EHR vendors athenahealth, Inc., and Greenway Medical Technologies are the first to integrate RxEvent reporting into their applications. More information The recent Society of Hospital Medicine Annual Meeting in Texas included presentation called “Strategies to Prevent Adverse Drug Events,” during which a team of hospitalist experts provided tips on ways to reduce the burden of adverse events and promoted the electronic post-discharge chart as a way to help patients and providers navigate the system and prevent medication errors. The experts called for a process redesign, focusing on 4 points: medication reconciliation redesign, patient counseling and coaching, post-discharge follow-up, and a greater role for pharmacists. Read more STOPP (Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions): Application to Acutely Ill Elderly Patients and Comparison with Beers’ Criteria Clinical pharmacists may wish to learn more about the differences between STOPP and Beers criteria in detecting adverse drug events from the following article. Authors: Gallagher P, O’Mahony D Abstract: STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions) is a new, systems-defined medicine review tool. The authors compared the performance of STOPP to that of established Beers’ criteria in detecting potentially inappropriate medicines (PIMs) and related adverse drug events (ADEs) in older patients presenting for hospital admission. They prospectively studied 715 consecutive acute admissions to a university teaching hospital. Diagnoses, reason for admission and concurrent medications were recorded. STOPP and Beers’ criteria were applied. PIMs with clear causal connection or contribution to the principal reason for admission were determined. STOPP identified 336 PIMs affecting 247 patients (35%), of whom one-third (n = 82) presented with an associated ADE. Beers’ criteria identified 226 PIMs affecting 177 patients (25%), of whom 43 presented with an associated ADE. STOPP-related PIMs contributed to 11.5% of all admissions. Beers’ criteria-related PIMs contributed to significantly fewer admissions (6%). View article
|
| NMPIC Patient Success Stories |
| Take Your PIC is introducing this new section, “Patient Success Stories,” which will highlight successful patient case studies in each issue.
Shaking the Salt: Mrs. G (63 years old) has been seen over the past several years by pharmacist Dr. Liddil, who has managed her hypertension. Mrs. G has a history of high blood pressure dating back to 1967. A few months ago Mrs. G’s blood pressure began to climb as high as 142/67 (goal is <130/80). Her blood pressure medication was lisinopril 40 mg. At that time Dr. Liddil began to educate Mrs. G about ways to bring her blood pressure into control, including exercise and low salt diet. After two months of the patient following Dr. Liddil’s recommendations, Mrs. G’s blood pressure had decreased to 103/63 without the addition of any medications. At her May visit, her blood pressure medication had been reduced to 5 mg of lisinopril, and her blood pressure was 99/56. Mr. A (59 years old) has been followed by Dr. Liddil for his anticoagulation with warfarin. His blood pressure is measured at each visit. In November 2010, his blood pressure was 138/71, and by April 2011 had reached 142/77. The patient uses a bicycle for transportation, and rides all over town every day. He did not want to add any medications to his warfarin, and was feeling fine with his blood pressure at this level. Dr. Liddil explained the dangers of high blood pressure to Mr. A, and questioned him about his salt use. Several suggestions were made regarding ways to cut back on salt, and he was also encouraged to lose a few pounds. On June 2, 2011, his blood pressure was 115/59. When he was congratulated about this, he replied “I did what you said: I cut out the salt, and I lost 5 pounds.”
|
| NMPIC News |
| HRSA PSPC: NMMRA is providing technical support to the three teams participating in the Health Resources and Services Administration (HRSA) Patient Safety and Clinical Pharmacy Services Collaborative (PSPC) and hosted locally the PSPC Web-based Learning Session 2, held over three days in June featuring different tracks and breakout sessions. PSPC participants and statewide partners participated in Blood Pressure, LDL – June 1; HIV, Anticoagulation – June 2; Asthma, Depression – June 3.
HIT: The HIT Advisory Board continues to work with the New Mexico Board of Pharmacy on upgrading the state prescription monitoring program. HIT Board representatives met with Board of Pharmacy leadership and its vendor on June 27 for a demonstration of the software and reporting capabilities. Taos Drug Abuse Project: A clinical champion was interviewed by a local radio station on the regional prescription drug abuse project. NMMRA was asked to present on the regional prescription drug abuse project at the next Senate Memorial 33 task force meeting. |
| This material was prepared by the New Mexico Medical Review Association (NMMRA), the Medicare Quality Improvement Organization for New Mexico, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.
9SOW-NM-PD-11-10For more information, see http://www.nmmra.org/providers/physician_medicare_nmpic.php DISCLAIMER
|
