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Am J Health Syst Pharm. 2018 Jun 1;75(11):774-783. doi: 10.2146/ajhp170346. Epub 2018 Apr 19.

Incorporating medication indications into the prescribing process.

Author information

1
Partners Healthcare, Somerville, MA.
2
Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA.
3
Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, and Partners Healthcare, Somerville, MA.
4
Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, and MCPHS University, Boston, MA.
5
Harvard Medical School, Boston, MA.
6
MCPHS University, Boston, MA.
7
School of Pharmacy, Chapman University, Irvine, CA.
8
Medication Outcomes Center, University of California San Francisco, San Francisco, CA.
9
Center for Patient Safety Research and Practice, Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA gschiff@bwh.harvard.edu.
10
Harvard Medical School, Boston, MA gschiff@bwh.harvard.edu.

Abstract

PURPOSE:

The incorporation of medication indications into the prescribing process to improve patient safety is discussed.

SUMMARY:

Currently, most prescriptions lack a key piece of information needed for safe medication use: the patient-specific drug indication. Integrating indications could pave the way for safer prescribing in multiple ways, including avoiding look-alike/sound-alike errors, facilitating selection of drugs of choice, aiding in communication among the healthcare team, bolstering patient understanding and adherence, and organizing medication lists to facilitate medication reconciliation. Although strongly supported by pharmacists, multiple prior attempts to encourage prescribers to include the indication on prescriptions have not been successful. We convened 6 expert panels to consult high-level stakeholders on system design considerations and requirements necessary for building and implementing an indications-based computerized prescriber order-entry (CPOE) system. We summarize our findings from the 6 expert stakeholder panels, including rationale, literature findings, potential benefits, and challenges of incorporating indications into the prescribing process. Based on this stakeholder input, design requirements for a new CPOE interface and workflow have been identified.

CONCLUSION:

The emergence of universal electronic prescribing and content knowledge vendors has laid the groundwork for incorporating indications into the CPOE prescribing process. As medication prescribing moves in the direction of inclusion of the indication, it is imperative to design CPOE systems to efficiently and effectively incorporate indications into prescriber workflows and optimize ways this can best be accomplished.

KEYWORDS:

CPOE; drug safety; medication errors; patient safety; patient-centered care; prescription drug indications

PMID:
29674327
DOI:
10.2146/ajhp170346

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