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Editor's Correspondence | Less Is More

Time to Change the Paradigm—From “Potentially Inappropriate” to Real Patient Harms

Nadine Shehab, PharmD, MPH; Daniel S. Budnitz, MD, MPH
Arch Intern Med. 2011;171(5):473-474. doi:10.1001/archinternmed.2011.48.
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The recent study by Mattison et al1 demonstrated a statistically significant reduction in potentially inappropriate (Beers criteria) medication (PIM) orders for hospitalized older patients after the introduction of a computerized provider order entry (CPOE) warning system; however, the authors provided no evidence that patient harms were reduced or outcomes were improved as a result of PIM warnings. Thus, we disagree with their conclusions that a reduction from 12 to 10 PIM orders per day is clinically significant, and we caution against overreliance on CPOE warnings of PIM use as a “tool for improving the safety of hospitalized older adults.”1(p1336)

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