Abstract
Objective
To determine the effect of introducing an electronic medication management system
(EMMS) on deprescribing practice in a post-acute hospital setting.
Design
This study used a before-after study design.
Setting and Participants
This study examined the admission and discharge medications prescribed to patients
admitted to an Australian post-acute hospital before and after the introduction of
an EMMS.
Methods
Data were collected over a 1-month period before and after the introduction of an
EMMS and included summary measures of drug burden including Potentially Inappropriate
Medications and the Drug Burden Index. We calculated and compared admission and discharge
medication prescription as well as change in medication use before and after the introduction
of an EMMS.
Results
Medication prescription data were available for 121 people before and 107 people after
EMMS introduction. In both phases, when compared with admission, those discharged
were prescribed fewer medications (mean reduction pre-EMMS = 2.9, P < .001, post-EMMS = 2.6, P < .001), fewer Potentially Inappropriate Medications (mean reduction pre-EMMS = 0.4,
P < .001, post-EMMS = 0.6, P < .001) and had lower Drug Burden Index (mean reduction pre-EMMS = 0.1, P < .001, post-EMMS = 0.2, P < .001). The degree of reduction in each measure was similar before and after EMMS
introduction.
Conclusions and Implications
The introduction of an EMMS did not affect deprescribing practice in a post-acute
hospital setting. Future work is required to explore the potential for clinical decision
support within an EMMS to further improve the safety and effectiveness of deprescribing
within post-acute care.
Keywords
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Article info
Publication history
Published online: November 21, 2020
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
