Prescription portal curbs deadly drug interactions

More than 11,000 adverse drug events were reported to HealthCanada in 2005, but the actual unreported numbers are much higher,according to IBM Canada research.

Many of these incidents could be prevented if doctors had theright information at their fingertips.

Unsafe practices – such as inappropriate prescriptions,inadequate monitoring, and harmful drug interactions – take theirtoll every year.

The Ottawa-based Canadian Pharmacists Association (CPhA) seeksto offer them that. The CPhA recently launched its e-Therapeuticsportal, an online knowledge management system that deliversup-to-date and unbiased drug information to healthcarepractitioners.

Developed in conjunction with Markham-based IBM Canada, theportal aggregates several disparate, largely paper-based sourcesinto a centralized e-repository.

Many factors contribute to adverse drug events, says NeilStuart, a partner in IBM Canada’s healthcare practice. The sheernumber, range and complexity of drugs available today feed into theproblem.

Stuart says drug therapy management is particularly difficultwhen patients are handed-off from one physician or specialist toanother for treatment. And the aging demographics of Canadiansociety means more and more people need treatment for chronicconditions such as diabetes, cardiovascular disease and arthritis.”Particularly with senior patients who are taking multiple drugs,it’s hard to manage the effects without some kind of knowledgetool.”

The difficulties of keeping up with the latest information areacute for general practitioners such as family physicians. Theymust cover the entire gamut of illnesses, says Stuart. But thevolume of material available is overwhelming. Medline, for example,a leading online database provided by the U.S. National Library ofMedicine, indexes about 4,000 articles annually on coronary diseasealone. “If a physician were to spend 15 minutes on each article, hewould require 115 8-hour days just to stay current – and that’sjust one disease,” says Stuart.

In addition to volume, e-Therapeutics also removes the biasesthat may exist in other sources.

“This issue relates to pharmaceutical companies and thesignificant amount of influence they have on the prescribing ofmedication,” says Dr. John Maxted, associate executive director ofthe Mississauga-based College of Family Physicians of Canada. “Theyspend a lot of money on these drugs and research, and then ofcourse they’re going to want to recover their investments by tryingto sell their products. To be fair, they are required by law tooutline all the contraindications and side-effects of theirmedications – but they also want to sell them.”

To eliminate this bias, the CPhA uses 130 authors – all expertsin their medical specialty areas – to develop content fore-Therapeutics. What they come up with, in turn, is cross-reviewedby panels of clinical authorities, says Diane Conrad, director ofproduct management, adding that the CPhA receives no funding frompharmaceutical companies.

In addition, the portal eliminates the ambiguity that U.S.-basedsources (which often list medications under different brand namesthan what are found in Canada) may introduce, she says.

The CPhA’s compendium of pharmaceutical information, a massivetome that physicians call the “blue bible”, has long been areliable source of information, says Maxted. Having a searchable,online version of the reference work incorporated in e-Therapeuticsis a godsend. “When you’re seeing 30 to 50 patients a day in familypractice, you can’t spend a lot of time looking up information oryou’ll never get through your day,” he says.

E-Therapeutics is one component of the larger effort to driveCanada’s healthcare system into the electronic age. “About 70 percent of physicians have Web access at the office, 45 per cent havea medical warning system on their PDAs, and only about 14 per centhave electronic medical records,” says Maxted. But this situationis changing rapidly, says IBM’s Stuart. “An increasing number ofmedical schools are requiring their students have PDAs becausethey’re building PDA use right into the curriculum.”

Integration of e-Therapeutics with other medical systems will bea big focus in the future. “Many provinces are in the process ofintroducing pharmacy information networks, which are transactionalsystems that manage the interface between prescribers and retailpharmacies,” says Stuart. “It would be terrific if this productcould be embedded in that.”

There are many projects planned under the auspices of CanadaHealth Infoway, a Montr

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