Electronic decision support tools help overcome problems related to polypharmacy

Polypharmacy is very common amongst elderly and multimorbid patients in general practice. There is evidence that polypharmacy is associated with increased harmful event rates, hospitalizations, and even untimely death. GPs may feel overwhelmed by the polypharmacy of their patients, being unable to make relevant decisions due to lack of data, knowledge and time.

In order to seek out solutions to this challenging topic, an international consortium of researchers with expertise in evidence-based medicine, clinical decision support, general practice and pharmacotherapy, developed the “PRIMA-eDS” tool, a comprehensive electronic decision support tool to support GPs in treating their older patients with polypharmacy.

The PRIMA-eDS* tool consists of two components: a data entry form to fill in timely patient data and a Comprehensive Medication Review® to support in reducing polypharmacy. The tool was evaluated in a large European randomized controlled trial and the results are published in British Medical Journal on June 2020

The results suggest that the use of the PRIMA-eDS tool enabled GPs to reduce the number of drugs the patient was taking (on average 0.8 per patient) without causing harm. In monetary terms, this can be translated to several hundred euros saved per year per patient. Moreover, reducing polypharmacy lowered the chance of hospital admission and death (non conclusive result).

The product version that was used in the study, was not integrated to any electronic health record (EHR) and many users noted that data input takes a long time. Comphrehensive Medication Review® has since been integrated into many EHRs removing entirely the need for manual data entry.

(Polypharmacy: Reduction of Inappropriate Medication and Adverse drug events in an older population by electronic Decision Support)

Duodecim Medical Publications Ltd, in collaboration with the PRIMA-eDS consortium, has developed a Comprehensive Medication Review® (CMR), which is an integral part of the clinical decision support system (EBMEDS®). Clinical decision support system EBMEDS® provides context-sensitive guidance at the point of care. It combines medical knowledge and patient data for improved care.