Using Electronic Medical Record Data to Characterize the Level of Medication Use by Age-Groups in a Network of Primary Care Clinics

Freund, Jeff; Meiman, Jon G; Kraus, Connie

doi:10.1177/2150131913495243

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…Some 52% of the participants had more than 4 prescribed drugs which was higher than in other studies reporting a prevalence based on health surveys of between 26 and 40% [54]. It was, however, closer to those authors employing electronic healthcare records [55] who observed over 50%. In our study, polypharmacy predicted NH entry, a fact that might be related to multimorbidity in addition to adverse drug reactions/ interactions, and greater risk of falls, and negative health outcomes [56].…”

Section: Polypharmacysupporting

confidence: 40%

The impact of frailty on admission to home care services and nursing homes: eight-year follow-up of a community-dwelling, older adult, Spanish cohort

et al. 2020

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Background: Frailty in older adults is a common multidimensional clinical entity, a state of vulnerability to stressors that increases the risk of adverse outcomes such as functional decline, institutionalization or death. The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. Methods: A prospective cohort study was conducted in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). The cohort was made up of 616 individuals. Data collection included a baseline multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, and the Central Registry of Catalonia for mortality. A prognostic index for a HC and NH at 8 years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine-Gray regression models were used. Results: At baseline, mean age was 76.4 years and 55.5% were women. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of Daily Living, number of prescriptions, and the presence of social risk.

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Section: Polypharmacysupporting

confidence: 40%

The impact of frailty on admission to home care services and nursing homes: eight-year follow-up of a community-dwelling, older adult, Spanish cohort

et al. 2020

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show abstract

“…Some 52% of the participants had more than 4 prescribed drugs which was higher than in other studies reporting a prevalence based on health surveys of between 26 and 40% [55]. It was, however, closer to those authors employing electronic healthcare records [56] who observed over 50%. In our study, polypharmacy predicted NH entry, a fact that might be related to multimorbidity in addition to adverse drug reactions/interactions, and greater risk of falls, and negative health outcomes [57].…”

Section: Polypharmacysupporting

confidence: 40%

The Impact of Frailty on Admission to Home Care Services and Nursing Homes: Eight-Year Follow-Up of a Community-Dwelling, Older Adult, Spanish Cohort

Cegri

Orfila

Abellana

et al. 2020

Preprint

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BackgroundFrailty in older adults is a common multidimensional clinical entity, a state of vulnerability to stressors that increases the risk of adverse outcomes such as functional decline, institutionalization or death. The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. MethodsA prospective cohort study was conducted in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). The cohort was made up of 616 individuals. Data collection included a baseline multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, and the Central Registry of Catalonia for mortality. A prognostic index for a HC and NH at eight years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine–Gray regression models were used. Results At baseline, mean age was 76.4 years and 55.5% were women. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of Daily Living, number of prescriptions, and the presence of social risk.ConclusionsPrognostic models based on comprehensive geriatric assessments can predict the need for the commencement of HC and NH admission in community-dwelling older adults. Our findings underline the necessity to measure functional capacity, mobility, number of prescriptions, and social aspects of older adults in primary healthcare centers. In such a setting they can be offered longitudinal holistic assessments so as to benefit from preventive actions in order to remain independent in the community for as long as possible.

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“…However, today’s state-of-the-art NLP programs are far from 100 % accurate—for example, their accuracy is poor because of the highly abbreviation-filled text of clinical notes [ 7 ]. Further, NLP information-extraction programs cannot be reused across all research applications [ 8 ]: to achieve high sensitivity and specificity, they must typically be tailored to specific problems, e.g., chronic pain [ 9 ], incontinence [ 10 ], and asthma [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Quality of EHR data extractions for studies of preterm birth in a tertiary care center: guidelines for obtaining reliable data

et al. 2016

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BackgroundThe use of Electronic Health Records (EHR) has increased significantly in the past 15 years. This study compares electronic vs. manual data abstractions from an EHR for accuracy. While the dataset is limited to preterm birth data, our work is generally applicable. We enumerate challenges to reliable extraction, and state guidelines to maximize reliability.MethodsAn Epic™ EHR data extraction of structured data values from 1,772 neonatal records born between the years 2001–2011 was performed. The data were directly compared to a manually-abstracted database. Specific data values important to studies of perinatology were chosen to compare discrepancies between the two databases.ResultsDiscrepancy rates between the EHR extraction and the manual database were calculated for gestational age in weeks (2.6 %), birthweight (9.7 %), first white blood cell count (3.2 %), initial hemoglobin (11.9 %), peak total and direct bilirubin (11.4 % and 4.9 %), and patent ductus arteriosus (PDA) diagnosis (12.8 %). Using the discrepancies, errors were quantified in both datasets using chart review. The EHR extraction errors were significantly fewer than manual abstraction errors for PDA and laboratory values excluding neonates transferred from outside hospitals, but significantly greater for birth weight. Reasons for the observed errors are discussed.ConclusionsWe show that an EHR not modified specifically for research purposes had discrepancy ranges comparable to a manually created database. We offer guidelines to minimize EHR extraction errors in future study designs. As EHRs become more research-friendly, electronic chart extractions should be more efficient and have lower error rates compared to manual abstractions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0592-z) contains supplementary material, which is available to authorized users.

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Using Electronic Medical Record Data to Characterize the Level of Medication Use by Age-Groups in a Network of Primary Care Clinics

Cited by 9 publications

References 24 publications

The impact of frailty on admission to home care services and nursing homes: eight-year follow-up of a community-dwelling, older adult, Spanish cohort

The impact of frailty on admission to home care services and nursing homes: eight-year follow-up of a community-dwelling, older adult, Spanish cohort

The Impact of Frailty on Admission to Home Care Services and Nursing Homes: Eight-Year Follow-Up of a Community-Dwelling, Older Adult, Spanish Cohort

Quality of EHR data extractions for studies of preterm birth in a tertiary care center: guidelines for obtaining reliable data

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