+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

An automated tool for detecting medication overuse based on the electronic health records



An automated tool for detecting medication overuse based on the electronic health records



Pharmacoepidemiology and Drug Safety 22(2): 183-189



Medication overuse is a serious concern in healthcare as it leads to increased expenditures, side effects, and morbidities. Identifying overuse is only possible through excluding appropriate indications that are primarily mentioned in unstructured notes. We developed a framework for automatic identification of medication overuse and applied it to proton pump inhibitors (PPIs). We first created an indications knowledge base using data from drug labels, clinical guidelines, expert opinion, and other sources. We also obtained the list of current problems for 200 randomly selected inpatients who received PPIs using a natural language processing system and the discharge summaries of those patients. These problems were checked against the indications knowledge base to identify overuse candidates. Two gastroenterologists manually reviewed the notes and identified cases of overuse. Results from the automated framework were compared with the manual review. Reviewers had high interrater reliability in finding indications (agreement = 92.1%, Cohen's κ = 0.773). In 137 notes included in the final analysis, our system identified indications with a sensitivity of 74% (95%CI = 59-86) and specificity of 95% (95%CI = 87-98). In cases of appropriate use where the automated system also found one or more indications, it always included the correct indication. We created an automated system that can identify established indications of medication use in electronic health records with high accuracy. It can provide clinical decision support for identifying potential overuse of PPIs and could be useful for reducing overuse and encouraging better documentation of indications.

(PDF emailed within 0-6 h: $19.90)

Accession: 036669458

Download citation: RISBibTeXText

PMID: 23233423

DOI: 10.1002/pds.3387


Related references

Trigger Tool-Based Automated Adverse Event Detection in Electronic Health Records: Systematic Review. Journal of Medical Internet Research 20(5): E198, 2018

Automated E-mail Reminders Linked to Electronic Health Records to Improve Medication Reconciliation on Admission. Pediatric Quality & Safety 3(5): E109-E109, 2018

A population health perspective on a claims and electronic health record-based tool to screen for suboptimal medication adherence. American Heart Journal 197: 150-152, 2018

Towards Drug Safety Surveillance and Pharmacovigilance: Current Progress in Detecting Medication and Adverse Drug Events from Electronic Health Records. Drug Safety 2019, 2019

Measuring overuse with electronic health records data. American Journal of Managed Care 24(1): 19-25, 2018

Improving patient safety and efficiency of medication reconciliation through the development and adoption of a computer-assisted tool with automated electronic integration of population-based community drug data: the RightRx project. Journal of the American Medical Informatics Association 25(5): 482-495, 2017

An Evidence-Based Tool for Safe Configuration of Electronic Health Records: The eSafety Checklist. Applied Clinical Informatics 9(4): 817-830, 2018

Potentially inappropriate medication prescribing in outpatient practices: prevalence and patient characteristics based on electronic health records. American Journal of Geriatric PharmacoTherapy 7(2): 84-92, 2009

Risks and benefits of psychotropic medication in pregnancy: cohort studies based on UK electronic primary care health records. Health Technology Assessment 20(23): 1-176, 2017

Comparing Population-based Risk-stratification Model Performance Using Demographic, Diagnosis and Medication Data Extracted From Outpatient Electronic Health Records Versus Administrative Claims. Medical Care 55(8): 789-796, 2017

Quality of nursing documentation: Paper-based health records versus electronic-based health records. Journal of Clinical Nursing 27(3-4): E578-E589, 2017

Medication Errors Despite Using Electronic Health Records: The Value of a Clinical Pharmacist Service in Reducing Discharge-Related Medication Errors. Quality Management in Health Care 25(1): 32-37, 2017

Effect of Electronic Health Record-Based Medication Support and Nurse-Led Medication Therapy Management on Hypertension and Medication Self-management: A Randomized Clinical Trial. JAMA Internal Medicine 178(8): 1069-1077, 2018

Medication discrepancies in integrated electronic health records. BMJ Quality and Safety 22(2): 103-109, 2015

Screening electronic veterans' health records for medication discontinuation. American Journal of Managed Care 18(7): 352-358, 2012