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Use of an on-demand drug-drug interaction checker by prescribers and consultants: A retrospective analysis in a Swiss teaching hospital


Beeler, Patrick Emanuel; Eschmann, Emmanuel; Rosen, Christoph; Blaser, Jürg (2013). Use of an on-demand drug-drug interaction checker by prescribers and consultants: A retrospective analysis in a Swiss teaching hospital. Drug Safety, 36(6):427-434.

Abstract

BACKGROUND: Offering a drug-drug interaction (DDI) checker on-demand instead of computer-triggered alerts is a strategy to avoid alert fatigue.
OBJECTIVE: The purpose was to determine the use of such an on-demand tool, implemented in the clinical information system for inpatients.
METHODS: The study was conducted at the University Hospital Zurich, an 850-bed teaching hospital. The hospital-wide use of the on-demand DDI checker was measured for prescribers and consulting pharmacologists. The number of DDIs identified on-demand was compared to the number that would have resulted by computer-triggering and this was compared to patient-specific recommendations by a consulting pharmacist.
RESULTS: The on-demand use was analyzed during treatment of 64,259 inpatients with 1,316,884 prescriptions. The DDI checker was popular with nine consulting pharmacologists (648 checks/consultant). A total of 644 prescribing physicians used it infrequently (eight checks/prescriber). Among prescribers, internists used the tool most frequently and obtained higher numbers of DDIs per check (1.7) compared to surgeons (0.4). A total of 16,553 DDIs were identified on-demand, i.e., <10 % of the number the computer would have triggered (169,192). A pharmacist visiting 922 patients on a medical ward recommended 128 adjustments to prevent DDIs (0.14 recommendations/patient), and 76 % of them were applied by prescribers. In contrast, computer-triggering the DDI checker would have resulted in 45 times more alerts on this ward (6.3 alerts/patient).
CONCLUSIONS: The on-demand DDI checker was popular with the consultants only. However, prescribers accepted 76 % of patient-specific recommendations by a pharmacist. The prescribers' limited on-demand use indicates the necessity for developing improved safety concepts, tailored to suit these consumers. Thus, different approaches have to satisfy different target groups.

Abstract

BACKGROUND: Offering a drug-drug interaction (DDI) checker on-demand instead of computer-triggered alerts is a strategy to avoid alert fatigue.
OBJECTIVE: The purpose was to determine the use of such an on-demand tool, implemented in the clinical information system for inpatients.
METHODS: The study was conducted at the University Hospital Zurich, an 850-bed teaching hospital. The hospital-wide use of the on-demand DDI checker was measured for prescribers and consulting pharmacologists. The number of DDIs identified on-demand was compared to the number that would have resulted by computer-triggering and this was compared to patient-specific recommendations by a consulting pharmacist.
RESULTS: The on-demand use was analyzed during treatment of 64,259 inpatients with 1,316,884 prescriptions. The DDI checker was popular with nine consulting pharmacologists (648 checks/consultant). A total of 644 prescribing physicians used it infrequently (eight checks/prescriber). Among prescribers, internists used the tool most frequently and obtained higher numbers of DDIs per check (1.7) compared to surgeons (0.4). A total of 16,553 DDIs were identified on-demand, i.e., <10 % of the number the computer would have triggered (169,192). A pharmacist visiting 922 patients on a medical ward recommended 128 adjustments to prevent DDIs (0.14 recommendations/patient), and 76 % of them were applied by prescribers. In contrast, computer-triggering the DDI checker would have resulted in 45 times more alerts on this ward (6.3 alerts/patient).
CONCLUSIONS: The on-demand DDI checker was popular with the consultants only. However, prescribers accepted 76 % of patient-specific recommendations by a pharmacist. The prescribers' limited on-demand use indicates the necessity for developing improved safety concepts, tailored to suit these consumers. Thus, different approaches have to satisfy different target groups.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute for Regenerative Medicine (IREM)
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2013
Deposited On:15 Dec 2014 14:16
Last Modified:16 Feb 2018 20:01
Publisher:Springer
ISSN:0114-5916
Additional Information:The final publication is available at Springer via http://dx.doi.org/10.1007/s40264-013-0022-1
OA Status:Green
Publisher DOI:https://doi.org/10.1007/s40264-013-0022-1
PubMed ID:23516005

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