BCBSRI takes aim at adverse drug reactions for seniors

PROVIDENCE – A pilot program launched by Blue Cross Blue Shield of Rhode Island and Brown Emergency Medicine aims to cut down on the number of adverse drug reactions experienced by patients who were recently discharged from the emergency room.

The EQUIPPED program, or Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department, targets patients 65 and up.

The program is designed to reduce adverse drug reactions and subsequent repeat emergency room visits by educating emergency department doctors on medication safety.

The Miriam Hospital plans to implement the program in mid-August, followed by Rhode Island Hospital three months later and Newport Hospital early next year.

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Although EQUIPPED is being tested at Lifespan hospitals initially, it will ultimately be used statewide, BCBSRI says.

According to the R.I. Department of Health, emergency room visits by patients of all ages across the state totaled 474,108 last year, down from more than 499,000 in 2017.

Dr. Elizabeth Goldberg, assistant professor of emergency medicine at Brown University, who launched EQUIPPED in Rhode Island, estimates that it will benefit about 30,000 seniors annually in the Ocean State. She adds that it will likely help younger patients as well by increasing physicians’ awareness on medications with potential sedative effects.

“By 2040 the population of Rhode Islanders 65 and older is expected to double and we need to be proactive in addressing their health needs and reducing the risk they experience from the drugs we prescribe,” Goldberg said.

Doctors will attend an initial seminar, and then meet with Goldberg or a pharmacist to discuss their monthly prescription output and what percentage of medications they are prescribing that are on are a list of potentially inappropriate drugs for older people. The program also tracks rates of potentially inappropriate prescriptions by physicians’ peers, to help doctors recognize if they are outliers, Goldberg said.

Written materials will also be provided to doctors, and reminder cards placed near computers where prescriptions are entered.

EQUIPPED was among the winning submissions from BCBSRI’s Provider Medical Expense Trend Summit, which focused on proposals for reducing rising medical costs.

The program, originally created by doctors at Emory University, is already in place at 11 veterans affairs medical centers and three other hospitals across the country, and has resulted in “significant and sustained” reductions in inappropriate medication prescriptions, BCBSRI said.

Elizabeth Graham is a PBN staff writer. She can be reached at Graham@PBN.com.