Nursing Home Medication Errors May Be Reduce by Mobile Apps: Study

Mobile device software, or apps, that give nursing home doctors access to drug reference databases appears to help prevent serious and potentially life-threatening medication errors, according to the findings of new research.  

In a study published this month by the Journal of the American Medical Director’s Association (JAMDA), researchers indicate that doctors working at nursing homes who use drug reference apps are less likely to give their elderly patients drug combinations that make them less likely to have a drug reaction due to a combination of drugs that should not be used together.

Having the information literally at their fingertips as they go through their day appears to be preventing nursing home patients from injury and potentially death.

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Researchers from the University of Pittsburgh surveyed 800 doctors at the 2010 American Medical Directors Association annual symposium, finding that about 560 used a mobile device to help prescribe drugs in nursing homes. The vast majority felt that their use had helped prevent at least one adverse drug event.

The study found that younger doctors, with 15 years or less experience, were 67% more likely to use drug reference software with a mobile device. Overall, 88% of the doctors who used those apps said that they believed that it had helped them prevent a drug reaction by alerting them of adverse side effects that could be the result of a drug combination. Almost all of those who used the apps performed an average of one or more drug look-ups per day, and one to two look-ups per day specifically for potential drug combination interactions.

In January, a study published in Drugs and Aging found that simply educating doctors about the risks linked to certain drugs cut down on adverse events. Researchers found that there was a nearly 10% drop in potential medication errors when doctors were given educational sessions that taught them about potential adverse events and focused on changing doctor behaviors.

In this latest study, researchers indicate that since their findings were based on doctors’ beliefs in how the apps had helped further research is needed to determine drug reference apps’ precise effect on nursing home medication errors.

Misuse of Drugs in Nursing Homes A Concern

The findings come amid ongoing concerns over the use of antipsychotics in nursing homes. Many powerful drugs, such as Risperdal, Paxil, and Seroquel, are often used as a form of chemical restraints to sedate nursing home residents, particularly those suffering from dementia. However, they may pose a serious health risk for residents.

Health experts are trying to put an end to the practice, which many consider to be a form of nursing home abuse. The FDA has determined that not only are antipsychotics not appropriate treatment for dementia patients, but that they also appear to increase the risk of death among those patients.

Officials in the nursing home industry indicate that much of the problem is linked to inadequate staffing that leads some to take the easy way out and sedate their residents with drugs.

In May 2011, the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG) issued a report on atypical antipsychotic misuse in nursing homes, which found off-label and dangerous use of the drugs was widespread.

The HHS-OIG report took data collected by the U.S. Centers for Medicare and Medicaid Services (CMS) in the first half of 2007 and found that 14% of the nation’s 2.1 million elderly nursing home residents were prescribed atypical antipsychotics at least once. Medical records indicate that 83% of those drugs were given for “off-label” reasons that were not approved by the FDA.

About 88% of the off-label uses were for conditions that the FDA cautioned against in black box warnings, the strongest label advisory the agency can give. The FDA warnings date back to 2005.


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