Featured Current NorTex Project
Identifying risks to medication safety in elderly patients during the COVID-19 pandemic from a provider perspective
Amidst the COVID-19 pandemic, primary health care providers transitioned rapidly to telehealth, showcasing this care delivery modality as an alternative to traditional face-to-face patient visits. This was particularly beneficial for patients who experience physical or financial barriers to health care access. Virtual appointments were safer and more convenient for high-risk individuals, such as elderly patients; however, the impacts on their care due to this shift are unclear.
Primary care providers, especially family medicine providers, are often responsible for medication management and health care maintenance for this population, and pill burden and polypharmacy continue to exacerbate the risk to medication safety. A 2019 study before the onset of COVID-19 found that, on average, 85% of elderly patients acknowledged that they frequently make mistakes with their medication.
This raises the question: How do primary care providers feel the integration of telehealth during the pandemic affected medication errors and patient safety? Medication errors are any preventable event that may cause or lead to inappropriate medication use or patient harm. As one of the most frequent causes of preventable adverse events, medication errors thus pose a severe risk to patient safety, especially for elderly patients with multiple prescriptions.
By understanding the capacity of virtual patient visits to manage and identify medication errors from a provider perspective, telemedicine can be used more confidently as a safe and comprehensive visit modality. Furthermore, recognizing which problems with medication management occur more frequently may shed light on areas for improvement in health care delivery and lead to future research.
Featured Completed NorTex Project
Bodyweight changes during COVID-19 for patients diagnosed with depression: a retrospective cohort study
Background: The objective of this study was to examine whether a diagnosis of depression is associated with changes in BMI during the COVID-19 pandemic for adults (aged ≥ 18 years).
Methods: A retrospective cohort study design used EHR data from a family medicine university clinic. Adults ≥ 18 years who visited the clinic within a six-month period prior to lockdown and at least once in the six month post-lockdown period were included. Diagnosis of depression, BMI and potential confounding variables were obtained from EHR. Mann- Whitney U was used to compare median change in BMI between depressed and nondepressed patients. Simple linear regression was used to identify the relationship between diagnosis of depression and BMI change. Multiple linear regression was used to control for age, sex, race/ethnicity, medications and chronic conditions; and to predict age effects in BMI change while stratified by diagnosis of depression and no diagnosis of depression.
Results: Statistical analysis showed that there was a significant difference in BMI changes (p<0.001) between the group diagnosed with depression and the group with no depression. Similarly, a diagnosis of depression significantly predicted BMI changes (p<0.001). This significance was maintained even while including confounding variables in the model (p=0.009). Further statistical analysis showed that age between 31 and 50 significantly predicted BMI changes in those patients with no depression while controlling for confounding variables (p=0.027).
Conclusion: This study demonstrated that individuals with depression had significant changes in BMI during the COVID-19 pandemic and age predicted these changes in middle-aged adults (30-50 years old). The significance of this finding places an importance in identifying and following up with individuals with a depression diagnosis given the effects on their BMI in extended isolation periods. Future studies could investigate other variables that might impact BMI change to influence the directionality of this relationship. Providing insight into this relationship could enable providers to inform patients who might be at risk for these types of changes over extended periods of isolation and hopefully result in positive patient health outcomes.
Elias Arellano completed his MS degree in the HSC School of Biomedical Sciences in May 2022.