Abstract Details

Title Impact of Best Practice Advisory on Reducing Contraindicated Medications and Improving Medication Management in Hospitalized Patients with Parkinson’s Disease

Topic Movement Disorders

Presentation(s) P7 - Poster Session 7 (5:00 PM-6:00 PM)

Poster/Presentation
Number 5-019

Objective To evaluate the impact of an electronic medical record (EMR) warning, also known as Best Practice Advisory (BPA), designed to reduce the administration of contraindicated dopamine-blocking agents and improve the adherence to home medication regimens for hospitalized patients with Parkinson’s disease (PD).

Background Patients with PD are at increased risk for complications during hospitalization due to complex medication regimens and the potential for receiving contraindicated medications such as dopamine antagonists. Failure to provide timely and accurate antiparkinsonian medications or exposure to dopamine blockers can worsen symptoms and lead to longer hospital stays.

Design/Methods This is a retrospective, observational cohort study reviewing medical records of around 200 patients diagnosed with PD who were admitted to Westchester Medical Center (WMC) between January 2023 and July 2024. The study compares the frequency of dopamine-blocking medication administration before and after the implementation of the BPA in September 2023. Also analyze if patients were given home medication regimens timely.

Results

Analysis 211 PD patients' chart review showed that 40.38% required antipsychotics for agitation, with 26.92% of them were prescribed first or second-generation antipsychotics, such as haloperidol or risperidone, while 73.08% received alternative including quetiapine or benzodiazepine. After the implementation of the BPA, this rate significantly decreased from 26.92% to 2.86%. Additionally, among 42.31% patients were ordered antiemetics, 10.20% of them were initially prescribed contraindicated antiemetics, including metoclopramide or prochlorperazine, which dropped to 0% following BPA initiation. Preliminary analysis of 40 patients also found that 45% of hospital orders did not match or given the patients' home doses of PD medications timely.

Conclusions The introduction of a BPA for dopamine-blocking agents significantly reduce the prescription of contraindicated medications for PD patients. Ongoing analysis and education will inform future safety initiatives and interventions aimed at improving care for this vulnerable patient population.

Authors/Disclosures
Zhimin Xu, MD, PhD (Westchester Medical Center) PRESENTER	Dr. Xu has nothing to disclose.
Andy Jiang, BS	Mr. Jiang has nothing to disclose.
Nishitha Bujala, MBBS (Kamineni Institute of Medical Sciences)	Dr. Bujala has nothing to disclose.
Colleen Bond, PharmD	Mrs. Bond has nothing to disclose.
Ariel Sacknovitz, Medical Student	Mr. Sacknovitz has nothing to disclose.
Carolin Dohle, MD	Dr. Dohle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion TPharmaceuticals. Dr. Dohle has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics.
Katherine D. Amodeo, MD (Westchester Medical Center)	The institution of Dr. Amodeo has received research support from Roche. The institution of Dr. Amodeo has received research support from EIP Pharma. The institution of Dr. Amodeo has received research support from Acadia. The institution of Dr. Amodeo has received research support from MJFF. The institution of Dr. Amodeo has received research support from NINDS.

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