Specific primary care strategies may improve medication safety
Primary care practices that used the same electronic health record (EHR) system independently developed a number of similar strategies for enhancing medication safety for their patients, according to a new study. Medication error, the most common form of medical error, occurs frequently in primary care settings. The most common strategies developed by practices within the Practice Partner Research Network (PPRNet) included ensuring that data on the medications each patient took were accurate and included nonprescription medicines—a process called medication reconciliation.
Practice strategies also included using comparable criteria to identify patients who experienced a preventable medication error, and customizing and applying decision-support tools to the EHR that would deal with medication dosing errors, drug-disease interactions, and ordering needed laboratory tests. The researchers noted a total of 32 distinct strategies, of which 11 were identified as key strategies to improve medication safety.
The study drew on site visits, from September 2008 through March 2009, to 20 PPRNet primary care practices representing 87 clinicians in 14 States. The practice model was designed to deal with five categories of medication problems: potentially inappropriate therapy, potentially inappropriate doses, potential drug–drug interactions, potential drug–disease interactions, and potential adverse drug events. The model included a series of change strategies, such as prioritizing performance, activating the patient, involving all staff, redesigning the system, and using EHR tools. The study was funded by the Agency for Healthcare Research and Quality (HS17037).
More details are in "Improving medication safety in primary care using electronic health records," by Lynne S. Nemeth Ph.D., R.N., and Andrea M. Wessell, Pharm.D., in the December 2010 Journal of Patient Safety 6(4); pp. 238-243.
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