Appl Clin Inform - A survey of nursing home physicians to determine laboratory monitoring adverse drug event alert preferences.

Tópicos

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Resumo

JECTIVE: We conducted a survey of nursing home physicians to learn about (1) the laboratory value thresholds that clinical event monitors should use to generate alerts about potential adverse drug events (ADEs); (2) the specific information to be included in the alerts; and (3) the communication modality that should be used for communicating them.METHODS: Nursing home physician attendees of the 2010 Conference of AMDA: The Society for Post-Acute and Long-Term Care Medicine.RESULTS: A total of 800 surveys were distributed; 565 completed surveys were returned and seven surveys were excluded due to inability to verify that the respondents were physicians (a 70% net valid response rate). Alerting threshold preferences were identified for eight laboratory tests. For example, the majority of respondents selected thresholds of =5.5 mEq/L for hyperkalemia (63%) and =3.5 without symptoms for hypokalemia (54%). The majority of surveyed physicians thought alerts should include the complete active medication list, current vital signs, previous value of the triggering lab, medication change in the past 30 days, and medication allergies. Most surveyed physicians felt the best way to communicate an ADE alert was by direct phone/voice communication (64%), followed by email to a mobile device (59%).CONCLUSIONS: This survey of nursing home physicians suggests that the majority prefer alerting thresholds that would generally lead to fewer alerts than if widely accepted standardized laboratory ranges were used. It also suggests a subset of information items to include in alerts, and the physicians' preferred communication modalities. This information might improve the acceptance of clinical event monitoring systems to detect ADEs in the nursing home setting.

Resumo Limpo

jectiv conduct survey nurs home physician learn laboratori valu threshold clinic event monitor use generat alert potenti advers drug event ade specif inform includ alert communic modal use communic themmethod nurs home physician attende confer amda societi postacut longterm care medicineresult total survey distribut complet survey return seven survey exclud due inabl verifi respond physician net valid respons rate alert threshold prefer identifi eight laboratori test exampl major respond select threshold meql hyperkalemia without symptom hypokalemia major survey physician thought alert includ complet activ medic list current vital sign previous valu trigger lab medic chang past day medic allergi survey physician felt best way communic ade alert direct phonevoic communic follow email mobil devic conclus survey nurs home physician suggest major prefer alert threshold general lead fewer alert wide accept standard laboratori rang use also suggest subset inform item includ alert physician prefer communic modal inform might improv accept clinic event monitor system detect ade nurs home set

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