{"id":41849,"date":"2019-01-23T14:43:39","date_gmt":"2019-01-23T19:43:39","guid":{"rendered":"https:\/\/www.ottawahospital.on.ca\/?p=41849"},"modified":"2020-09-23T15:41:57","modified_gmt":"2020-09-23T19:41:57","slug":"medsafer-tool-helps-doctors-improve-prescriptions-for-older-patients","status":"publish","type":"post","link":"https:\/\/www.ottawahospital.on.ca\/en\/healthy-tomorrows\/medsafer-tool-helps-doctors-improve-prescriptions-for-older-patients\/","title":{"rendered":"MedSafer: tool helps doctors improve prescriptions for older patients"},"content":{"rendered":"

Paula Tiszai (left) believes that patients like her mother, Ritva Tiszai, could be helped by MedSafer, an automated, computer-assisted tool that helps doctors and pharmacists review medications and, when appropriate, stop some to help reduce adverse drug events.<\/em><\/p>\n

Paula Tiszai worries constantly about her 85-year-old mother\u2019s medications. Over the years, she has seen her mother suffer deliriums, behavioural issues, problems eating, falls and more \u2013 simply because she was on inappropriate drugs (such as antipsychotics) or wrong doses.<\/p>\n

\u201cShe couldn\u2019t walk, she couldn\u2019t function, she couldn\u2019t speak, and it was all this medication that wasn\u2019t helping \u2013 it was hindering her,\u201d said Paula. \u201cShe has this fear of needles now because of what happened.\u201d One time, her mother, who has dementia, became agitated in hospital while on an antipsychotic drug. \u201cThey held her down and called security instead of me. They didn\u2019t know her baseline. I just happened to show up and said, \u2018That\u2019s not what she\u2019s like\u2019.\u201d<\/p>\n

Paula believes patients like her mother, Ritva Tiszai, could be helped by the MedSafer<\/a> project, which runs at The Ottawa Hospital from October 2018 to Spring 2019.<\/p>\n

MedSafer is an electronic tool to help doctors and pharmacists decide which medications could be stopped. The tool screens the patient\u2019s medical history and medications and then gives prioritized recommendations for taking the patient off drugs that are no longer needed, or could cause unintended side effects or reactions with other drugs. The tool draws on the evidence-based criteria in the Choosing Wisely Canada, Beers, and START\/STOPP lists.<\/p>\n

\"Rita

Rita Tiszai (front) has dementia and has suffered deliriums, behavioural issues, problems eating, falls and more \u2013 simply because she was on inappropriate drugs (such as antipsychotics) or wrong doses. Her loved ones believe MedSafer can help.<\/p><\/div>\n

MedSafer\u2019s goal is to reduce adverse drug events, which account for 27,000 hospital admissions per year in Canada. Severe adverse drug events lead to as much as 20 percent of all hospitalizations in the elderly, who are the most likely to be using five or more medications at once. Reviewing medications can prevent many of these adverse drug events.<\/p>\n

\u201cThis is the biggest study in the world of this type, so it\u2019s a world-first,\u201d said Dr. Allen Huang, who is co-leading (along with Dr. Alan Forster, Dr. Babak Rashidi and Pharmacist Derek Dyks) the Ottawa section of a Canada-wide clinical trial to study how effective MedSafer is at reducing post-discharge adverse drug events, falls in hospital, lengths of stay, and readmissions.<\/p>\n

\u201cIt\u2019s like using Google Maps in an unfamiliar city,\u201d explained Dr. Huang, Head of Geriatric Medicine at The Ottawa Hospital and the University of Ottawa. \u201cMedSafer will help guide you.\u201d<\/p>\n

\u201cToo many patients have been on certain drugs for years, long after they should have been reviewed and stopped,\u201d said Dr. Huang. \u201cFor example, a woman may have had postpartum depression and been put onto antidepressants 30 years go, but she\u2019s still taking the drug today because no one has ever done a review.\u201d<\/p>\n

\u201cIt\u2019s one of those things that touches everyone,\u201d said Kira Slivitzky, Clinical Research Assistant, who is enrolling patients in the MedSafer trial. \u201cThey like not having to worry about having so many medications or at least tapering down.\u201d<\/p>\n

MedSafer\u2019s recommendations will be sent to family doctors after the patient is sent home, so that family doctors can continue to monitor medications.<\/p>\n

\u201cIn the past, they tended to overmedicate,\u201d said Paula. \u201cIf they mask the problem by giving them drugs, patients can\u2019t tell them what\u2019s wrong, such as pain or discomfort. She went through World War II \u2013 she can\u2019t be forced to do anything. Gentle methods work. By using a gentle approach, the patient can tell them what\u2019s wrong.\u201d<\/p>\n

Paula\u2019s mother is doing much better these days, on fewer medications.<\/p>\n

\u201cThe more they\u2019ve reduced the medication, the better the improvement,\u201d she said.<\/p>\n

The clinical trial, funded by the Canadian Institutes of Health Research, is taking place in 11 hospitals across Canada, from Montreal to Vancouver.<\/p>\n

Dr. Huang and his colleagues are also exploring how MedSafer could, in future, be integrated into Epic \u2013 the digital health information network that will go live at The Ottawa Hospital in June 2019.<\/p>\n

Conservative estimates have found that using an electronic medication prescribing system that automatically detects problems before they happen can save a hospital like The Ottawa Hospital $4 million a year in adverse drug events and legal action. Dr. Huang said MedSafer could save potentially even more because it also includes a complete review of all a patient\u2019s medications and conditions.<\/p>\n

\u201cIt takes it to the next level.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Paula Tiszai worries constantly about her 85-year-old mother\u2019s medications. Over the years, she has seen her mother suffer deliriums, behavioural issues, problems eating, falls and more \u2013 simply because she was on inappropriate drugs. Paula believes MedSafer could help.<\/p>\n","protected":false},"author":25,"featured_media":41850,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[9],"tags":[67,413,409],"class_list":["post-41849","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-tomorrows","tag-innovation","tag-patient-safety","tag-senior-health"],"acf":[],"wps_subtitle":"","_links":{"self":[{"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/posts\/41849","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/users\/25"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/comments?post=41849"}],"version-history":[{"count":0,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/posts\/41849\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/media\/41850"}],"wp:attachment":[{"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/media?parent=41849"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/categories?post=41849"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ottawahospital.on.ca\/en\/wp-json\/wp\/v2\/tags?post=41849"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}