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Randomized Controlled Trial
. 2008 Apr;23(4):399-404.
doi: 10.1007/s11606-007-0482-z.

An electronic medical record (EMR)-based intervention to reduce polypharmacy and falls in an ambulatory rural elderly population

Valerie Weber  1 , Alan White, Robb McIlvried
Affiliations
Randomized Controlled Trial

An electronic medical record (EMR)-based intervention to reduce polypharmacy and falls in an ambulatory rural elderly population

Valerie Weber et al. J Gen Intern Med. 2008 Apr.

Abstract

Background: Falls are the leading cause of injury-related deaths in the aging population. Electronic medical record (EMR) systems can identify at-risk patients and enable interventions to decrease risk factors for falls.

Objective: The objectives of this study were to evaluate an EMR-based intervention to reduce overall medication use, psychoactive medication use, and occurrence of falls in an ambulatory elderly population at risk for falls.

Design: Prospective, randomized by clinic site.

Patients/participants: Six-hundred twenty community-dwelling patients over 70 at risk for falls based on age and medication use.

Interventions: A standardized medication review was conducted and recommendations made to the primary physician via the EMR.

Measurements and main results: Patients were contacted to obtain self reports of falls at 3-month intervals over the 15-month period of study. Fall-related diagnoses and medication data were collected through the EMR. A combination of descriptive analyses and multivariate regression models were used to evaluate differences between the 2 groups, adjusting for baseline medication patterns and comorbidities. Although the intervention did not reduce the total number of medications, there was a significant negative relationship between the intervention and the total number of medications started during the intervention period (p < .01, regression estimate -0.199) and the total number of psychoactive medications (p < .05, regression estimate -0.204.) The impact on falls was mixed; with the intervention group 0.38 times as likely to have had 1 or more fall-related diagnosis (p < .01); when data on self-reported falls was included, a nonsignificant reduction in fall risk was seen.

Conclusions: The current study suggests that using an EMR to assess medication use in the elderly may reduce the use of psychoactive medications and falls in a community-dwelling elderly population.

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References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '2648154', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/2648154/'}]}
    2. Tinetti ME, Speechley M. Prevention of falls among the elderly. N Engl J Med. 1989;320:1055–9. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/archinte.164.15.1621', 'is_inner': False, 'url': 'https://doi.org/10.1001/archinte.164.15.1621'}, {'type': 'PubMed', 'value': '15302631', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15302631/'}]}
    2. Curtis LH, Ostbye T, Sendersky V, et al. Inappropriate prescribing for elderly Americans in a large outpatient population. Arch Intern Med. 2004;164:1621–5. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '10719768', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/10719768/'}]}
    2. Bath PA, Pendleton N, Morgan K, et al. New approach to risk determination: development of risk profile for new falls among community-dwelling older people by use of a Genetic Algorithm Neural Network (GANN). J Gerontol A Biol Sci Med Sci. 2000;55(1):M17–21. Jan. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '2738307', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/2738307/'}]}
    2. Campbell AJ, Borrie MJ, Spears GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol. 1989;44(4):M112–7. July. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '8890119', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/8890119/'}]}
    2. Monane M, Avorn J. Medications and falls. Clin Geriatr Med. 1996;12:847–58. - PubMed

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