Background:

The elderly population is particularly vulnerable to adverse drug events. As the population ages preventing these ADEs will become increasingly important. Our objective was to decrease the use of potentially inappropriate medication in hospitalized elders (65 years or older) using a computerized drug warning system.

Method:

We performed an observational study on the inpatient wards of an academic tertiary care medical center. All inpatients 65 years or older admitted to the hospital from March 1, 2005 through November 30, 2005 were included. When ordering providers attempted to order a potentially inappropriate medication (as determined by the Beers' criteria) for a patient 65 years or older, an alert was generated through the online computer order entry system. The ordering provider had the option of accepting the warning and choosing a different medication or overriding the warning and continuing with the order. The number of attempts to order potentially inappropriate medications as well as the number of overrides was recorded each month.

Summary of Results:

The computer warnings decreased the rate of ordering potentially inappropriate medications by 9‐31% in hospitalized patients 65 years and older. Ordering providers attempted to ordereach medication roughly the same number of times from month to month throughout the study showing no evidence for a learning effect. Moreover, the percent of overrides does not seem to increase with time demonstrating no extinguishing effect either.

Statement of Conclusions:

Computerized drug warning systems can be effective in reducing the prescribing patterns of potentially inappropriate medication in the elderly and should be further studied to ensure generalizability across other domains of practice. Additional research might elucidate ways to minimize the percent of overrides and further decrease the use of potentially inappropriate medication use.

Author Disclosure Block:

M.L.P. Mattison, None.