Abstract
Objective: Evaluate an inpatient intervention to reduce rates of hospital related complications in patients with Parkinson’s disease (PD).
Background: Several interventions have been suggested to reduce known inpatient complications in hospitalized PD patients but there are no data driven recommendations currently reported.
Design/Methods: A hospital wide alert system was incorporated into the EMR of Dignity Health affiliated hospitals in Arizona. Extensive in-services were done with providers and staff. Charts of subjects with PD admitted 6 months before and after the intervention were reviewed for baseline demographics, compliance with the intervention, and outcomes.
Results: 73 patients (mean age 73 years, mean disease duration 7.2 ± 9.1 years) in the pre-intervention group, 103 patients (mean age 72 years, mean disease duration 7.0 ± 6.4 years) in the post-intervention group were included. There were no significant differences among reasons for admission, admission to neurological vs non-neurological floor, or the service the patients were admitted to between the groups. The percentage of patients for whom contra-indicated medications ordered decreased from 42.5% to 17.5% (p<0.001). Medication administration within 30 minutes of scheduled time went from 36% to 53%, and doses given over 30 minutes went from 46% to 39% (p=0.068). Medications ordered by home schedule was 42.9% vs 54.7% (p=0.131) before and after the intervention. Length of stay was 5.3 vs 5.2 days (p=0.896) and mean number of complications was 0.38 vs 0.37 (p=0.864).
Conclusions: An intervention involving EMR alerts and in-service didactics decreased the frequency of contraindicated medications ordered in hospitalized PD patients.
Disclosure: Dr. Aslam has nothing to disclose. Dr. Simpson has nothing to disclose. Dr. Baugh has nothing to disclose. Dr. Shill has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Abbvie and Sunovion. Dr. Shill has received research support from Biogen, Dong-A ST Co., Ltd., MagQu. Intec Pharma, Ltd, US World Meds, and Sunovion/Cynapsus Therapeutics, Inc..
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