Navigating Prescribing Challenges in the Age of AI Technology
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Chapter 1: The Shift in Prescribing Practices
The traditional method of consulting the Physicians’ Desk Reference (PDR) is becoming obsolete as technology rapidly advances, making it essential for healthcare providers to adapt. Andrew von Eschenbach notes the increasing complexity of prescribing information, which has become denser and harder to navigate over the past decade.
“Take one and call me in the morning” is a phrase many patients used to hear, and in some cases, still do. This practice is not only outdated but raises serious questions about the quality of care. As time passes, some healthcare professionals find themselves relying on outdated tools and methods.
In a world where technology evolves at an unprecedented pace, it is crucial for practitioners to do more than just remember the basics of pharmacology. Yet, many continue to stick to conventional practices.
Continuing Medical Education (CME) is intended to keep professionals informed about the latest in medicine. However, I've attended sessions where participants were more focused on their phones than the presentations, prioritizing refreshments and quick exits over meaningful learning. Some even signed in just to leave shortly after.
CME events are not solely focused on medical advancements; they often promote pharmaceutical products. Presenters can earn significant sums for their talks, leading to questions about how this influences their subsequent prescribing habits.
Chapter 2: The Role of AI in Prescribing
The last printed edition of the PDR was released in 2017, but it is now accessible for free online and via mobile applications. While these tools offer valuable information, they cannot replace the need for thorough decision-making, especially for patients on multiple medications.
AI serves as a decision-support tool for healthcare providers, enhancing their efficiency and offering a broader range of treatment options. Far from diminishing human interaction in medical care, AI can assist in streamlining processes, updating electronic health records (EHR), and suggesting alternatives.
Meskó believes that AI will soon become integral to healthcare, aiding physicians in their clinical judgments much like the stethoscope did decades ago. AI shows significant promise in diagnostics and prescribing, particularly in the realm known as Narrow AI, which focuses on specific tasks.
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Section 2.1: Concerns in Continuing Medical Education
A commentator highlights a troubling trend: “Continuing medical education has become so reliant on funding from pharmaceutical and medical device companies that the medical community may have lost control over its own educational processes.”
While CME sessions provide valuable niche insights, it remains the prescriber’s duty to recognize harmful combinations of medications, particularly in older patients. As the population ages, understanding these complexities becomes increasingly crucial.
Starting in 2030, all baby boomers will exceed 65 years of age, resulting in older Americans constituting 21% of the population, an increase from 15% today. Projections indicate that by 2060, nearly one in four Americans will be aged 65 and older, with the number of centenarians increasing significantly.
The challenges posed by this demographic shift may lead to polypharmacy, where patients are prescribed multiple medications. This situation can increase the likelihood of encountering potentially inappropriate medications (PIMs) that adversely affect long-term health outcomes.
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Section 2.2: The Complexities of Aging and Medication
The gradual onset of iatrogenic illnesses can begin innocently. For instance, a patient prescribed medication for high blood pressure may develop swollen ankles, leading to a diuretic prescription. This can cascade into a series of additional medications to counteract side effects, creating a complex web of treatments.
Could AI systems in prescribing offices promptly address these cascading medication interactions? By rapidly analyzing patient data, AI can assist providers in determining suitable medication regimens, proving its value in modern healthcare.
Chapter 3: The Future of Prescribing with AI
In recent years, concerns over RAM usage in smartphones have evolved, now encompassing programs designed for medication management. These applications not only store patient data but also alert prescribers to potential errors and contraindications, highlighting the growing need for advanced prescribing tools.
A significant study reviewed over 26,000 free text notes accompanying prescriptions, revealing that more than 66% included inappropriate content. Such findings underscore the necessity for effective software solutions in healthcare, as complexity and genetic factors further complicate prescribing.
Addressing human error with AI is vital; however, software can also produce errors, particularly when data is flawed. Ongoing research into medical algorithms is essential for overcoming these challenges and ensuring safe prescribing practices.
