Navigation Links
Lab monitoring tests not always ordered per recommendations
Date:6/26/2014

Why does one physician in a walk-in practice order laboratory monitoring tests for patients more often than a colleague working down the hallway? Which factors influence the use of these important tests that can help doctors ensure that high-risk drugs are prescribed safely? Clues to these questions lie in the age and general health of the patient, and whether the doctor is a specialist or not, says Shira Fischer of the Beth Israel Deaconess Medical Center in Boston. She is the lead author of a study which appears in the Journal of General Internal Medicine, published by Springer.

Laboratory tests help doctors to monitor the condition of their patients, and to ensure that prescribed drugs work effectively and safely in treating high-risk conditions. However, these are not always performed, even in cases where such tests are advised before a new round of medicines can be dispensed. This can lead to medical errors and influence patient safety, as was highlighted in the US Institute of Medicine's report "To Err is Human." There are no US national guidelines about appropriate laboratory monitoring, and experts do not agree on the appropriate standards of monitoring.

To ascertain the factors that influence how and when physicians order laboratory tests, Fischer and her colleagues conducted research at the Meyers Primary Care Institute in Massachusetts, studying the electronic medical records of 31,417 patients and 278 providers in a large multispecialty New England group practice. The study includes information about prescriptions for 34 high-risk conditions and their 60 associated tests.

For recommended tests, the rate of physician ordering varies greatly, with for example almost all patients taking potassium receiving an order for a potassium level (95 percent) but less than half of patients on Lithium receiving orders for a blood count (42 percent) or creatinine level (49 percent), as is recommended. Tests measured yearly (for example, Digoxin level) were more likely to be ordered than those required more often (for example, AST/ALT levels in patients on Rifampin).

Specialists are more likely to order the recommended tests for the medications used in the study than primary care providers. Older patients, men and people already using other medications are also tested more regularly. Younger patients and people who do not often visit doctors seldom received test orders. Younger physicians and those who are familiar with the testing guidelines associated with a specific medication are also more likely to use laboratory tests to monitor their patients.

The researchers also found that the so-called "black box warnings"* on certain medications regularly alert practitioners to the need to run associated tests. These warnings can be required by the US Food and Drug Administration and are the strongest ones around in prescription drug labeling. Even so, not everyone takes heed of them.

"Interventions to improve laboratory monitoring should focus on areas with the greatest potential for improvement, such as providers who do not prescribe medication much, or those who prescribe medication to healthier and younger patients, or once-off walk-in patients," advises Fischer, who believes it is worthwhile to provide "black box warnings" on medications shown to be highest-risk to educate physicians about the importance of laboratory monitoring.


'/>"/>

Contact: Joan Robinson
joan.robinson@springer.com
49-622-148-78130
Springer
Source:Eurekalert

Related medicine news :

1. Role of Screening, Monitoring in Early Kidney Disease Unclear
2. QuickMedical® Offers The WaveSense Blood Glucose Monitoring System
3. Better monitoring of food quantity makes self-control easier
4. Environmental Monitoring in China Industry Research Report – Now Available from IBISWorld
5. Smart stethoscope advance in monitoring treatment of kidney stones
6. This Holiday Season, Family and Friends of People with Breathing Problems are Choosing the Ideal Gift for Monitoring Lung Health: the Spiro PD Personal Spirometer
7. Blood Pressure Monitoring and Measurement Instruments Market - New Industry Research Report is Now Available for Pre Order at Transparency Market Research
8. IOM report details strategy for monitoring safety of childhood immunization schedule
9. Institute of Medicine report details for monitoring safety of childhood immunization schedule
10. The Boston Eye Group Implants First Intraocular Pressure Transducer for Glaucoma Monitoring
11. Aircraft Health Monitoring Systems Market is expected to reach $992.0 Million by 2017 with a CAGR of 2.1% - by MarketsandMarkets
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/26/2017)... ... April 26, 2017 , ... Infertility may be a ... and has helped many women become pregnant upon treating their diagnosis. ... simple outpatient evaluations. We can provide the necessary information to diagnose and ...
(Date:4/26/2017)... ... 2017 , ... New SUPRO® XT55 Isolated Soy Protein ... helping beverage manufacturers more effectively manage protein costs. “Soy protein has always been ... as more stable pricing over time. Now it’s even more relevant as plant ...
(Date:4/25/2017)... ... April 25, 2017 , ... ... Mirroring360 Pro . This new addition to the Mirroring360 product family combines ... and business. , Mirroring360 Pro enables educators, business professionals and individuals to stream ...
(Date:4/25/2017)... (PRWEB) , ... April 25, 2017 , ... ... CEOs, CFOs and HR decision-makers are preparing for how his administration could impact ... will provide insight into what changes are most likely to make it through ...
(Date:4/25/2017)... ... 25, 2017 , ... Patients who would like to straighten ... fraction of the time as traditional braces – Wilckodontics®. Dr. Victoria Chen, an ... this revolutionary treatment with or without a referral. , Wilckodontics is also ...
Breaking Medicine News(10 mins):
(Date:4/19/2017)... NEW YORK , April 19, 2017 ... Surgical drainage devices are tubes used to remove excess ... include, blood, serum, pus, urine, bile or lymph. Surgical ... types of surgery such as orthopedics surgery, cardiovascular surgery, ... device is prophylactic post-surgery to prevent accumulation of fluid ...
(Date:4/19/2017)... 2017 Companion animal ... in pets such as canine, avian and feline. ... types such as Attenuated Live Vaccines, Conjugate Vaccines, ... and Recombinant Vaccines. Attenuated live vaccines are derived ... which have been weakend under laboratory conditions. Conjugate ...
(Date:4/18/2017)... 2017 Cogentix Medical, Inc. (NASDAQ: CGNT), a ... Uro/Gyn and Gynecology markets with innovative and proprietary products, ... March 31, 2017 after the market close on Tuesday, ... host a conference call and webcast to discuss its ... 2017 at 4:30 p.m. Eastern Time (3:30 p.m. Central ...
Breaking Medicine Technology: