Evidence Table 6KQ1: Primary Process outcomes for all technologies assisting education and other aspects of medication management

Article InformationHIT Studied
Integrated systems
SettingsOutcomes MeasuredResultsOutcome
Agrawal (2009)230
Design: Before- after
N = 19,356 MedRecon events
Implementation: 06/2006
Study Start: 08/2006
Study End: 12/2007
CDSS/CDS/CCDS/reminders medication reconciliation at admission, transfer and discharge
Integrated CPOE/POE system, EHR/EMR system
Unspecified Hospital, 630 Beds Other, Academiccompliance with performing medication reconciliation*On a monthly basis, clinicians performed medication reconciliation more often after the MedRec system and its reminder system were in place. Compliance improved from approximately 34% to 98% to 100%, statistically significant improvement.+
Grasso (2002)231
Design: Before- after
N = 200 discharge summaries
Implementation: 04/2001
Study Start: 06/2000
Study End: 07/2001
PDA use to construct discharge summaries Handheld
Integrated EHR/EMR system, Pharmacy
Other specialty hospital (rehab, oncology), Inpatient hospital basederrors rateThe rate of errors in discharge summaries from a psychiatric hospital decreased after the implementation of PDAs to produce the summaries (22% vs. 8%, RRR 64%, p <0.05).+
Poole (2006)232
Design: Before- after
N = 100 patients
Implementation: 00/0000
Study Start: 00/0000
Study End: 00/0000
Medication Reconciliation Discharge System
Integrated e-MAR, Hospital information system
General Hospital, Inpatient hospital basedfrequency discrepancies *, Dose discrepancies*, Therapeutic drug duplication discrepancies*The PDMW was found to be effective in reducing discrepancies in frequency and dose and reducing therapeutic drug duplication at the time of discharge. Resolution of discrepancies in frequency improved by 65% with the tool (18% vs. 76%, p <0.001).. Resolution of discrepancies in dosages improved by 60% (28% vs. 82%, p <0.001), and therapeutic drug duplication was addressed in 58% more cases (p <0.001).+
Quinn (2008)127
Design: RCT
N = 30 patients
Implementation: 00/0000
Study Start: 00/0000
Study End: 00/0000
CDSS/CDS/CCDS/reminders
Diabetes Management Tool
Integrated Web-based data analytics and therapy optimization tools
Ambulatory carechanges in medication (medication intensified)Patients using WellDoc System were more likely to have physicians intensify diabetes medications (84.6% vs. 23.08%, p = 0.002).+
van der Kam (2001)233
Design: Cohort study
N = 1,149 medications
Implementation: 00/0000
Study Start: 02/1998
Study End: 05/1998
e-Rx, Pharmacy information system
Integrated Pharmacy
Unspecified Hospital, Pharmacy, Not specifiedAgreement of GP and pharmacist with patient for drug reported on admission, Agreement of GP and pharmacist with patient for drug reported on 10 days after dischargeAgreement of GP and pharmacist with patient for drugs reported was 31% for paper-based group compared to 49% for electronic group on admission (RRR 58%, p <0,001). The figures on 10 days after discharge were 33% and 53% respectively (RRR 61%, p <0.001). Total number of drugs reported by patients on admission was 38% and 29% for paper- based and electronic groups respectively. The figures on 10 days after discharge were 38% and 28% respectively.+

The HIT system studied is in bold, followed by the systems that it was integrated with. The outcome column indicates whether at least 50% of the relevant outcomes abstracted were positively impacted by the MMIT (+) or not (−).

*

indicates outcomes noted as being the primary outcome by the paper’s authors

Abbreviations: GP = General Practitioner; HIT = Health Information Technology; N= Sample Size; p = Probability; PDA = Personal Digital Assistants; PDMW = Physician Discharge Medication Worksheet; RRR = Relative Risk Reduction; vs. = Versus

From: Appendix C, Evidence Tables

Cover of Enabling Medication Management Through Health Information Technology
Enabling Medication Management Through Health Information Technology.
Evidence Reports/Technology Assessments, No. 201.
McKibbon KA, Lokker C, Handler SM, et al.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.