Gerios checking is NOT applied for medications ordered from templates.
A medication are defined as gerios if it is contraindicated, or if it should be administered with adjustments to the dosing and/or frequency, when used for treatment of the elderly. Orders for patients who are at or above the age cutoff on the date of admission (the age cutoff depends on the medication—usually 60 or 65 years or older) qualify for gerios interventions.
Gerios checking is NOT applied for medications ordered from templates.
A medication are defined as nephros if it is contraindicated, or if it should be administered with adjustments to the dosing and/or frequency, when used for treatment of adult patients with renal insufficiency.
Patients who are 19 years or older on the date of admission are defined as adults for this intervention.
Renal insufficiency is defined by a creatinine clearance calculated from the patient's weight, height, and serum creatinine level. If the patient does not have a serum creatinine result in the CDR (Clinical Data Repository) that is less than a year old, the nephros intervention is not triggered.
Creatinine clearance is calculated using the Cockcroft and Gault equation. If the patient does not have a non-chemo weight and height on file, you will be prompted to provide this information. Ideal body weight (IBW) is used in this equation if the patient is overweight (actual weight > IBW).
The level of impairment with renal insufficiency depends on the creatinine clearance value. Mild impairment is indicated when the result is 80 or less; moderate at 50 or less, and severe at 15 or less.
Both age and renal sufficiency may be checked for a given medication—in other words, a med may be defined as both nephros and gerios. In this case, the priority of one or the other is part of the definition.
The level of intervention is defined for each medication affected. If an adjustment to the dosing and/or frequency is recommended, this information is displayed on a Nephros/Gerios tab on the medication order form and in the zoom detail of the order. For gerios adjustments, the age cutoff is included in the details. The recommended dosing and frequency are presented as the default. If the medication is contraindicated for the patient, recommendation or substitution is presented.