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Practices and preferences for detecting chronic medication toxicity: a pilot cross‐sectional survey of health care providers focusing on decision support systems
Author(s) -
Dischinger Hannah R.,
Cheng Elizabeth,
Davis Lisa A.,
Caplan Liron
Publication year - 2014
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12192
Subject(s) - medicine , cross sectional study , health care , clinical decision support system , family medicine , digital health , medical emergency , decision support system , nursing , data mining , pathology , computer science , economics , economic growth
Rationale, aims, and objectives Adverse drug reactions ( ADRs ) are a critical concern: they are costly, both in dollars and in diminishing patients' quality of life. ADRs that occur due to prolonged exposure to a pharmaceutical agent (adverse drug reactions of long latency, ADRLLs ) may be easier to prevent than acute ADRs , as ADRLLs inherently require continued medication exposures. This pilot study used glucocorticoid‐induced osteoporosis ( GIO ) as an example ADRLL . The aims were to survey health care providers' current practices in avoiding ADRLLs and the perceived utility of decisional support systems ( DSS ) to aid them in preventing GIO . Methods We administered an anonymous, cross‐sectional survey to health care providers (fellows, doctor assistants, nurse practitioners and attending doctors) focusing on their methods to monitor for and prevent ADRLLs . The questionnaire also gauged usage of electronic medical records ( EMRs ) and each provider's perceived utility of specific DSS ‐based approaches to monitoring for GIO . Data were interpreted using descriptive statistics and histograms. Results A majority of the 33 responding providers (84.8%) reported that their primary ADRLL avoidance technique is simply remembering that a patient is on chronic glucocorticoids. The most favourably perceived DSS options included tracking medications on a flow sheet (84.8%) and digital tracking of cumulative glucocorticoid exposure with real‐time prompts (83.9%). Conclusions Surveyed providers reported that additional DSS implementation may help in the avoidance of ADRLLs such as GIO . Providers ranked both digital and non‐digital DSS favourably, but a computerized approach is appealing in that it may be integrated into extant EMR systems.

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