Impact of best practice advisory on reducing contraindicated medications in hospitalized patients with Parkinson's disease.

BACKGROUND

Patients with Parkinson's disease (PD) face heightened risks during hospitalization, including prolonged hospital stay and discharge to higher levels of care. Possible contributing factors include non-adherence to home medication regimens and administration of contraindicated medications.

OBJECTIVE

To evaluate the impact of Best Practice Advisory (BPA), integration into Electronic Medical Records (EMRs) aimed at minimizing the prescription of contraindicated dopamine blocking agents (DBA) in hospitalized PD patients.

METHODS

This is a single center, retrospective, cohort study comparing frequency of administration of contraindicated medications before and after implementation of a BPA at Westchester Medical Center (WMC) between January 2023 and July 2024. The primary outcome is the prescription of DBA. Secondary outcomes included discharge level of care, and hospital length of stay.

RESULTS

Two-hundred and eleven charts were reviewed, and patients with confirmed diagnosis of PD or related Parkinsonism, who were prescribed dopaminergic medications at the time of admission were included. After BPA implementation, there was a statistically significant drop in rates of contraindicated prescriptions for psychosis and antiemetics, 33.33 %-2.86 % (p < 0.001) and 11.11 %-0 % (p < 0.001), respectively. There were no significant changes in LOS or discharge to higher levels of care between periods.

CONCLUSION

Implementing a BPA effectively reduced the prescription of contraindicated medications for PD patients. This highlights the value of targeted BPAs in improving PD patient safety and lays the groundwork for further medication quality improvement initiatives aimed at optimizing inpatient care for this vulnerable population.