Brigham and Women's is evaluating patients at risk from taking multiple medications

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Brigham and Women's Hospital in Boston has paired with Israeli startup FeelBetter on a retrospective study of patients at risk due to taking multiple medications.

The simultaneous use of multiple medications to treat diseases and other health conditions, called polypharmacy, is common among older adults with chronic conditions.

"We know, especially for individuals over age 65, there are adverse interactions with medications," said Dr. Lisa Rotenstein, principal investigator of the study, which is expected to be published in early 2023. Rotenstein is medical director of Population Health, Primary Care Center of Excellence at Brigham and Women's Hospital.

The pilot study has several aspects, including the use of algorithms to evaluate senior patients with multiple chronic conditions and complex medication regimens of three or more prescriptions. FeelBetter's SaaS risk stratification is being applied to data from patients who were treated at the hospital from 2016 and 2019. 

The software synthesizes and analyzes healthcare data from multiple sources to predict which patients have the highest risk of deterioration, hospitalization and incurring financial costs from suboptimal polypharmacy, according to FeelBetter. 

WHY THIS MATTERS

The study is not intended as an intervention to avoid hospitalization but may have that effect.

"This is really about knowing about the medications and using that information in a way that can help us alter medication regimens," Rotenstein said. "There is an opportunity to identify which patients are at risk of adverse events related to medication regimens and to develop solutions which help clinical teams take action in advance." 

Physicians usually know what medications patients are taking from information in the EHR. But even with this knowledge, patients are often seeing multiple physicians and medication regimens may change, she said. 

The study will assess decision-support capabilities to provide actionable medication management recommendations such as stopping a medication or changing its dose.

Study results will include estimates of the potential annual reduction in total medical expenditures, particularly those associated with avoidable emergency department visits and hospitalizations, FeelBetter said. 

THE LARGER TREND 

Polypharmacy is a growing public health concern in senior patients and paves the way for medication non-adherence, drug reactions, adverse events and poor health outcomes, as well as increased use of healthcare services and rising costs, according to FeelBetter.

According to a 2019 report by the Centers for Disease Control and Prevention, 83% of Americans in their 60s and 70s took at least one prescribed medication in the previous 30 days and approximately one-third used five or more prescription drugs, most commonly to manage cholesterol, high blood pressure and diabetes, the company said. 

Every year, suboptimal medication management results in 275,000 deaths and more than $528 billion in avoidable costs in the United States, according to FeelBetter.

Brigham and Women's Hospital is the first healthcare organization in the United States to evaluate FeelBetter's solution, the company said. 

The Tel Aviv-based company said a recent retrospective pilot with 153,000 managed care patients at Leumit Health Services in Israel showed that usage of the FeelBetter solution could help organizations synthesize and analyze healthcare data from multiple sources to accurately report which patients are affected most from suboptimal polypharmacy and are likely to have an avoidable hospitalization within 30-90 days. 

FeelBetter's investors include FirstTime Ventures, GoodCompany Ventures, Random Forest VC and Triventures.

ON THE RECORD

Dr. Adva Tzuk Onn, FeelBetter's CMO, said by statement: "The study with Brigham and Women's Hospital will enable us to further validate our solution's ability to personalize medication regimens and improve patient journeys, while supporting efforts to transition to value-based care."

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org