Bosco Chan1,2, Emily Reeve1,2,3, Slade Matthews2, Peter R Carroll1,2, Janet C Long3, Fabian Held4, Mark Latt2,5, Vasi Naganathan2,6, Gideon A Caplan7,8, Sarah N Hilmer1,2,3. 1. Kolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, Sydney, Australia. 2. Sydney Medical School, University of Sydney, Sydney, Australia. 3. Cognitive Decline Centre, University of Sydney, Sydney, Australia. 4. Faculty of Science, School of Mathematics and Statistics, Charles Perkins Centre, The University of Sydney, Sydney, Australia. 5. Department of General, Geriatric and Rehabilitation Medicine, Royal Prince Alfred Hospital, Sydney, Australia. 6. Centre for Education and Research on Ageing, University of Sydney and Ageing and Alzheimers Institute, Concord Hospital, Australia. 7. Department of Geriatric Medicine, Prince of Wales Hospital, Sydney, Australia. 8. University of New South Wales, Sydney, Australia.
Abstract
AIMS: Effective transfer of information is vital for rational drug therapy. This is particularly important for older patients, who have a high prevalence of polypharmacy and are managed by multidisciplinary teams. We aimed to assess medicine information exchange (MIE) networks in geriatric medicine wards and whether they are associated with prescribing patterns. METHODS: We conducted network analysis in acute geriatric medicine wards from four hospitals to characterize MIE networks among multidisciplinary team members. Corresponding patient data were collected to analyze high-risk prescribing in conjunction with network characteristics. RESULTS: We found that junior doctors, senior nurses and pharmacists were central to MIE across all four hospitals. Doctors were more likely than other professions to receive medicines information in three hospitals. Reciprocity and the tendency to communicate within one's own profession also influenced network formation. No difference was observed in prescribing practice between hospitals. CONCLUSIONS: Understanding MIE networks can identify gaps in multidisciplinary communication that can be addressed. Networks may identify targets for dissemination of interventions to improve prescribing.
AIMS: Effective transfer of information is vital for rational drug therapy. This is particularly important for older patients, who have a high prevalence of polypharmacy and are managed by multidisciplinary teams. We aimed to assess medicine information exchange (MIE) networks in geriatric medicine wards and whether they are associated with prescribing patterns. METHODS: We conducted network analysis in acute geriatric medicine wards from four hospitals to characterize MIE networks among multidisciplinary team members. Corresponding patient data were collected to analyze high-risk prescribing in conjunction with network characteristics. RESULTS: We found that junior doctors, senior nurses and pharmacists were central to MIE across all four hospitals. Doctors were more likely than other professions to receive medicines information in three hospitals. Reciprocity and the tendency to communicate within one's own profession also influenced network formation. No difference was observed in prescribing practice between hospitals. CONCLUSIONS: Understanding MIE networks can identify gaps in multidisciplinary communication that can be addressed. Networks may identify targets for dissemination of interventions to improve prescribing.
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