Inpatient prescribing and monitoring of XXXX transdermal systems: adherence to safety regulations.

@entity1 @entity137 @entity283 @entity1576 @entity158 @entity1118 @entity3575
BACKGROUND: National safety guidelines were developed to minimize the occurrence of serious @entity137 ( @entity137 ) associated with the use of the @entity3575 transdermal system (FTS), however, reports of use in opioid-na  ve @entity1 for treatment of acute @entity158 and associated @entity137 continue to occur. OBJECTIVE: To evaluate the prescribing patterns of the FTS for adherence to recent US regulatory recommendations and identify the impact of @entity283 ( @entity283 ) on adherence rates. METHODS: A retrospective pre- and postintervention analysis was performed in hospitalized adult @entity1 receiving FTS. Electronic medication order instructions and text questions were incorporated into FTS electronic medication orders. The primary outcome measure was adherence of FTS medication orders to regulatory guidelines defined as (a) a new order in an opioid-tolerant @entity1 for use in moderate to severe @entity1118 or (b) continuation of the documented home dose in use for at least 7 days. Safety measures included respiratory rate and documented @entity137 . RESULTS: Adherence rates were significantly increased in the postintervention cohort as compared to the preintervention cohort (48.7% vs 85.0%; P < .0001). Incidence of @entity137 was significantly lower post intervention (34.7% vs 23.3%; P = .043), including a lower incidence of @entity1576 (16.7% vs 8.3%; P = .043). Documentation was increased in the postintervention cohort (76% vs 100%). However, supporting documentation confirmed responses in only 59.2% of records reviewed. CONCLUSIONS: Incorporation of @entity283 via electronic order text questions increased overall adherence rates to regulatory recommendations, increased documentation, and decreased the rate of associated @entity137 .
