Mark Makowsky|Ken Cor|Tat Wing Wong
Exploring Electronic Medical Record and Self-Administered Medication Risk Screening Tools in a Primary Care Clinic
University of Alberta|Grey Nuns Community Hospital|Alberta Hospital Edmonton|University of Alberta|Grey Nuns Community Hospital|Alberta Hospital Edmonton|Grey Nuns Community Hospital|University of Alberta|Alberta Hospital Edmonton
background electronic medical record emr screening indicators medication risk could improve efficiency identifying primary care clinic patients need clinical pharmacist care compared patient selfreportingobjectives compare performance emr medication risk assessment questionnaire mraq selfadministered sa mraq b explore tools ability predict indicators health behavior health status health care utilizationmethods prospective cohort study conducted 143 adults attended academic family medicine center taking 2 medicationsall participants completed 10item samraq morisky medication adherence scale chews health literacy screener stanford health distress scale sf36 overall rating healtha blinded investigator completed emrmraq chart review ascertain 6 months health care utilizationoutcome measures included following scores 5and 10item samraqs 5item emrmraq b sensitivity specificity determine accuracy 5item emr versus 5item sa risk scores c correlations risk assessments health behaviorstatus scales area receiver operator curve determine well highrisk score predicted health care utilization resultsthe 5item samraq 5item emrmraq 10item samraq categorized 529 55104 692 99143 176 18102 participants high risk respectivelyfor 104 participants completed 5item mraq tools emrmraq sensitivity 818 specificity 490 detecting highrisk samraq scoreboth 5item risk assessments showed weak correlations health distress overall health 10item samraq additionally showed weak correlations medication adherencethe emrmraq effective predicting allcause emergency room visitshospitalization cstatistic 069 95 ci057081and high clinic utilization 4 visits per 6 months cstatistic 077 95 ci 069085the emrmraq high sensitivities low specificities health care utilization outcomes respectively 826 333 889 427conclusions pilot study suggests emrmraq screening high sensitivity low specificity comparison selfreporting able discriminate would would experience health care utilization outcomesthese results justify development validation automated emrbased tool predict patientimportant consequences medicationrelated problems