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

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