Evidence mapPaperPMID 39770429Full record

ArticlePharmaceuticals (Basel, Switzerland)2024

Individual Pharmacotherapy Management (IPM-II) for Patient and Drug Safety in Polypharmacy via Clinical Electronic Health Record Is Associated with Significant Fall Prevention.

Ursula Wolf, Luise Drewas, Hassan Ghadir, Christian Bauer, Lars Becherer, Karl-Stefan Delank, Rüdiger Neef

Abstract read
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Article in Pharmaceuticals (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Ursula WolfPharmacotherapy Management, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany.
Luise DrewasInternal Medicine Clinic II, Martha-Maria Hospital Halle-Dölau, 06120 Halle (Saale), Germany.
Hassan GhadirDepartment of Internal Medicine/Cardiology, Johanniter-Hospital Geesthacht, 21502 Geesthacht, Germany.
Christian BauerDepartment of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany.
Lars BechererDepartment of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany.
Karl-Stefan DelankDepartment of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany.ORCID 0000-0003-4691-3588
Rüdiger NeefDepartment of Orthopaedics, Trauma and Reconstructive Surgery, Division of Geriatric Traumatology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesFalls and fractures are emerging as a near-pandemic and major global health concern, placing an enormous burden on ageing patients and public health economies. Despite the high risk of polypharmacy in the elderly patients, falls are usually attributed to age-related changes. For the "Individual Pharmacotherapy Management (IPM)" established at the University Hospital Halle, the IPM medication adjustments and their association with in-hospital fall prevention were analysed.

methodsOn the basis of the most updated digital overall patient view via his inpatient electronic health record (EHR), IPM adapts each drug's Summary of Product Characteristics to the patient's condition. A retrospective pre-post intervention study in geriatric traumatology on ≥70 years old patients compared 200 patients before IPM implementation (CG) with 204 patients from the IPM intervention period (IG) for the entire medication list, organ, cardiovascular and vital functions and fall risk parameters.

resultsStatistically similar baseline data allowed a comparison of the average 80-year-old patient with a mean of 11.1 ± 4.9 (CG) versus 10.4 ± 3.6 (IG) medications. The IPM adjusted for drug-drug interactions, drug-disease interactions, overdoses, anticholinergic burden, adverse drug reactions, esp. from opioids inducing increased intrasynaptic serotonin, psychotropic drugs, benzodiazepines, contraindications and missing prescriptions. IPM was associated with a significant reduction in in-hospital falls from 18 (9%) in CG to 3 (1.5%) in IG, a number needed to treat of 14, relative risk reduction 83%, OR 0.17 [95% CI 0.04; 0.76],

conclusionThe results indicate medication risks constitute a major iatrogenic cause of falls in this population and support the use of EHR-based IPM in standard care for the prevention of falls in the elderly and for patient and drug safety. In terms of global efforts, IPM contributes to the running WHO and United Nations Decade of Healthy Ageing (2021-2030).

Indexed as

ageddrug safetyfall preventionIndividual Pharmacotherapy Management (IPM)in-hospital fallsinpatient Electronic Health Record (EHR)pathophysiological conditionspatient safetypolypharmacy

Identifiers

PMID39770429
PMCPMC11676629

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