Primary Sense: Development of an Automated World Class Medication Governance System for Australian General Practice

Description

Introduction
Preventable adverse drug events result in harm and hospital admissions1. Safe, effective and judicious use of medication in general practice requires constant vigilance by the doctor because there is limited and inadequate decision support from current prescribing software2. In-built medication alerts do not combine information from across the electronic record and fail to prompt deprescribing.
Aims
We aimed to develop and test an automated medication governance system for Australian General Practice.
Methods
Data extracted from general practice electronic medical record were analysed continuously to provide real-time computer decision support based on the patient’s demographic, medications, diagnoses, laboratory monitoring, lifestyle risks and physical measurements.
Results
Primary Sense was able to provide alerts related to deprescribing opportunities, genomics, physical measures, patient demographics, lifestyle, renal function trends, monitoring requirements, co-morbidities and co-prescribing requirements.
Alerts were presented at the time of prescribing or at the time new pathology results were received in the practice. Alerts provided evidence-based recommendations tailored to individual patients. Response by GPs was able to be tracked.
Conclusions and relevance
A comprehensive computerised Medication Governance System is both feasible and necessary to establish excellence in medication management in Australian general practice.
References
1. Howard et al. Which drugs cause preventable admissions to hospital? A Systematic Review. British Journal of Clinical Pharmacology 2007
2. Marcilly et al. Usability flaws of medication-related alerting functions: A systematic Qualitative review. Journal of Biomedical Informatics; 2015

Period	1 Dec 2018
Held at	5th Annual Australian Deprescribing Network (ADeN) Annual Meeting 2018
Event type	Conference
Location	Adelaide, Australia
Degree of Recognition	National