Detection of Drug-Related Problems through a Clinical Decision Support System Used by a Clinical Pharmacy Team

• Published in: Healthcare (Basel) 2023-03, Vol.11 (6), p.827
• Main Authors: Robert, Laurine, Cuvelier, Elodie, Rousselière, Chloé, Gautier, Sophie, Odou, Pascal, Beuscart, Jean-Baptiste, Décaudin, Bertrand
• Format: Article
• Language: English
• Subjects: Adverse and side effects; Clinical decision making; clinical decision support system (CDSS); Clinical medicine; clinical pharmacist; Collaboration; Decision support systems; Drug dosages; Drug stores; Drug utilization; drug-related problems; Drugs; Hospitals; Intervention; Laboratories; Life Sciences; Methods; Pharmacists; Physicians; Prescriptions; Technology application
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare11060827

Clinical decision support systems (CDSSs) are intended to detect drug-related problems in real time and might be of value in healthcare institutions with a clinical pharmacy team. The objective was to report the detection of drug-related problems through a CDSS used by an existing clinical pharmacy team over 22 months. It was a retrospective single-center study. A CDSS was integrated in the clinical pharmacy team in July 2019. The investigating clinical pharmacists evaluated the pharmaceutical relevance and physician acceptance rates for critical alerts (i.e., alerts for drug-related problems arising during on-call periods) and noncritical alerts (i.e., prevention alerts arising during the pharmacist's normal work day) from the CDSS. Of the 3612 alerts triggered, 1554 (43.0%) were critical, and 594 of these 1554 (38.2%) prompted a pharmacist intervention. Of the 2058 (57.0%) noncritical alerts, 475 of these 2058 (23.1%) prompted a pharmacist intervention. About two-thirds of the total pharmacist interventions (PI) were accepted by physicians; the proportion was 71.2% for critical alerts (i.e., 19 critical alerts per month vs. 12.5 noncritical alerts per month). Some alerts were pharmaceutically irrelevant-mainly due to poor performance by the CDSS. Our results suggest that a CDSS is a useful decision-support tool for a hospital pharmacist's clinical practice. It can help to prioritize drug-related problems by distinguishing critical and noncritical alerts. However, building an appropriate organizational structure around the CDSS is important for correct operation.