Provision of personal digital assistants alone does not help providers avoid drug-drug interactions
Incomplete knowledge of a patient's medication history commonly contributes to prescribing errors such as drug-drug interactions (DDIs). Unfortunately, patients don't always disclose everything they are taking. Use of a personal digital assistant (PDA) by physicians to update patient medication histories did not reduce the rate of potential drug-drug interactions, according to a new study. In fact, the researchers found that the PDA was not frequently used by the physicians to update medication histories.
A total of 1,615 prescribers received a wireless PDA for medication management. This group was compared to 600 prescribers who did not receive the device. Each provider's prescribing history for a single State's Medicaid population was reviewed during a 1-year baseline period and then again 1-year later. The wireless handheld PDA gave the physician real-time access to patient medication histories along with comprehensive drug information and potential drug-drug interactions.
At the start of the study, 68.4 percent of the PDA group and 74.8 percent of the comparison group had no potential DDIs of interest. After 1 year, these percentages were 70 percent and 77 percent, respectively. The most widely prescribed potential DDIs involved warfarin (a blood thinner) with nonsteroidal anti-inflammatory drugs. Following adoption of the PDA, there was a gradual increase in the number of patient medication history update requests. PDA use peaked during the first half of the study period; it then declined and finally stabilized.
The rate of e-prescribing using the PDA was low, with an average of 2 prescriptions submitted electronically for every 1,000 claims. No significant differences were found between the two groups regarding the change in the rate of potential DDIs from the baseline to the follow-up period. The study was supported in part by the Agency for Healthcare Research and Quality (HS10385).
See "Evaluation of a wireless handheld medication management device in the prevention of drug-drug interactions in a Medicaid population," by Daniel C. Malone, PhD, and Kimberly R. Saverno, PhD, in the January/February 2012 Journal of Managed Care Pharmacy 18(1), pp. 33-45.
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