Electronic prescribing for high-risk meds may contribute to patient falls among elderly

Medications considered high-risk for seniors can often be prescribed at higher than recommended levels when distributed in accordance with hospital EMR default doses. These high dosage levels may contribute to patient falls, according to a recent study published in the Journal of the American Geriatrics Society.

The study examined electronic prescription rates for opioids, muscle relaxants, sleep medications and tranquilizers in seniors who experienced an inpatient fall. In total, 328 occurrences of patient falls among seniors were examined. Researchers found prescription levels were often higher than expert-recommended dosage levels for geriatrics. For example, benzodiazepines and benzodiazepine-receptor agonists were prescribed at higher than recommended rates 57 percent of the time.

"Before the widespread use of electronic prescribing, physicians had to consciously determine the appropriate drug dosage for an individual," said Rosanne Leipzig, MD, PhD, a geriatric medicine specialist with Mount Sinai Hospital in New York and one of the study's authors. "This study highlights that with electronic prescribing, default doses do matter and lowering defaults for vulnerable patient groups such as elderly patients may be an easy way to reduce inappropriate use of high risk drugs for these patients."

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