Patient-centered IT-support for quality and safety of drug use in older adults: The QS-project

PI: Johan Fastbom, johan.fastbom@ki.se

Drug use in older adults is extensive and increasingly complex. Drug-related problems are common, and one of the more serious consequences is that between 10% and 30% of hospital admissions in older adults are due to adverse drug reactions. Reducing drug-related illness older adults would have profound health and financial effects. However, it has proven difficult to reduce drug-related illness with existing interventions, such as pharmacist-led drug utilization reviews. This project investigates whether a freely available web-based drug information and support system for older adults (SeniorminiQ) and a tool for assessing risks for unsafe drug use (the Safe Medication Assessment instrument or SMA) can be used, alone or together, to improve drug use in older adults. SeniorminiQ allows the older adult or a relative to enter information about current drug use and symptoms. It then generates a printout with relevant questions on the appropriateness of the drug use that can be taken to a doctor’s appointment.

In this project, we examine patients’ and physicians’ opinions about the benefits of SeniorminiQ and estimate its effects on the quality of drug use. We investigate whether SeniorminiQ and a computerized version of the SMA efficiently and sensitively detect drug-related problems when used in combination by district nurses during preventive home visits to 75-year-olds. Additionally, we study whether the quality analysis in SeniorminiQ can be used together with the safety assessment in SMA to signal the need for a drug utilization review. Finally, we explore whether physicians can use their version of the miniQ to retrieve data from SeniorminiQ in order to review patients’ drug use.

The project introduces a model (SeniorminiQ) in which patients are involved in optimizing the quality and safety of their drug treatment and physicians retain responsibility for drug utilization reviews with appropriate support from nurses.