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Clinical decision support for monitoring drug-drug-interactions and potassium-increasing drug combinations: need for specific alerts


Eschmann, Emmanuel; Beeler, Patrick E; Kaplan, Vladimir; Schneemann, Markus; Zünd, Gregor; Blaser, Jürg (2012). Clinical decision support for monitoring drug-drug-interactions and potassium-increasing drug combinations: need for specific alerts. In: Mantas, John; Andersen, Stig Kjær; Mazzoleni, Maria Christina; Blobel, Bernd; Quaglini, Silvana; Moen, Anne. Quality of Life through Quality of Information. Amsterdam: IOS Press, 1200-1202.

Abstract

Computer-triggered reminders alerting physicians on every potentially harmful drug-drug-interaction (DDI) induce alert fatigue due to frequent messages of limited clinical relevance. On demand DDI-checks, however, are not commonly used by physicians. Optimal strategies for sustained quality assurance have to consider patients' risk factors and focus on the most significant DDIs only. An approach is proposed based on the analysis of concurrent prescription of potassium-sparing diuretics and potassium supplements (CPPP), which are the most frequent DDIs classified as contraindicated. Although the frequency of monitoring potassium serum levels declined during prolonged periods of CPPP, the likelihood of observing a hyperkalaemia increased. The median treatment period of CPPP was 3.3 days, whereas hyperkalaemia occurred after a median observation time of 4.5 days of CPPP. Thus, computer-triggered reminders for ordering potassium serum levels may be indicated if monitoring has been discontinued after 48h of CPPP.

Abstract

Computer-triggered reminders alerting physicians on every potentially harmful drug-drug-interaction (DDI) induce alert fatigue due to frequent messages of limited clinical relevance. On demand DDI-checks, however, are not commonly used by physicians. Optimal strategies for sustained quality assurance have to consider patients' risk factors and focus on the most significant DDIs only. An approach is proposed based on the analysis of concurrent prescription of potassium-sparing diuretics and potassium supplements (CPPP), which are the most frequent DDIs classified as contraindicated. Although the frequency of monitoring potassium serum levels declined during prolonged periods of CPPP, the likelihood of observing a hyperkalaemia increased. The median treatment period of CPPP was 3.3 days, whereas hyperkalaemia occurred after a median observation time of 4.5 days of CPPP. Thus, computer-triggered reminders for ordering potassium serum levels may be indicated if monitoring has been discontinued after 48h of CPPP.

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Additional indexing

Item Type:Book Section, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
04 Faculty of Medicine > Institute for Regenerative Medicine (IREM)
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2012
Deposited On:13 Feb 2013 11:37
Last Modified:07 Dec 2017 18:50
Publisher:IOS Press
Series Name:Studies in Health Technology and Informatics
Number:180
ISSN:0926-9630
ISBN:978-1-61499-100-7 (print), 978-1-61499-101-4 (online)
Publisher DOI:https://doi.org/10.3233/978-1-61499-101-4-1200
Related URLs:http://ebooks.iospress.nl/publication/21952
http://ebooks.iospress.nl/volume/quality-of-life-through-quality-of-information (Publisher)
PubMed ID:22874400

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