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A recently developed electronic health record tool that adjusts medication doses for older adults specifically lowered adverse drug events, a new report showed. 

Researchers weren’t sure how the Geriatric Prescribing Context (GPC) would affect adverse drug events that can occur during hospitalization. The team evaluated rates of adverse events before the tool rolled out and after, and found out that the model worked to lower the potentially fatal events.

In fact, older adults hospitalized before the tool launched were 2.3 times more likely to have a dose-related adverse drug event compared to patients who were admitted to the hospital after it was launched, according to the study published on Jan. 19 in the Journal of the American Geriatrics Society.

The team led by Kathleen Drago, MD, a researcher from Oregon Health and Science University, identified adverse drug events from medical codes associated with 10 commonly used medicines. Hospitalized older adults may be at risk for getting potentially inappropriate medication (PIM) doses because electronic health records have dosing defaults that may not be right for older adults. The tool automatically triggers information on alternate doses for 51 medications that are often used in older adults. When a clinical enters the electronic health records, it triggers information on alternate dosing for anyone over the age of 75.  

The scientists evaluated differences in the number of hospital admissions with an adverse drug event before and after the GPC was launched at OHSU Hospital and integrated into the electronic health records. The pre-launch period was from July 2016 through June 2017 and the post-launch period was from August 2017 through July 2018. Specifically, the team compared the rate of adverse drug events per 1,000 patient days between the time periods and assessed differences in harm categories.

The proportion of people admitted to the hospital with dose-related adverse drug events slipped from 0.0082 to 0.0037 after the GPC was launched. The rate of dose-related adverse drug events also went down after the launch; it was 2.5 per 1000 patient days before the launch and 1.1 per 1000 patient days. The harm categories did not change significantly between the time periods.