Computer-based system for preventing adverse drug events

Silverman, Jon; Stapinski, Carl; Huber, Camilla; Ghandi, Tejal K.; Churchill, William

doi:10.1093/ajhp/61.15.1599

Cited by 32 publications

(29 citation statements)

References 4 publications

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“…[20] Each of these 5 signals were associated with the presence of abnormal laboratory values. There is no evidence about PPVs of signals generated by a clinical event monitor in the MICU, so these signals were selected based on their performance in other settings.…”

Section: Methodsmentioning

confidence: 99%

Computerized detection of adverse drug reactions in the medical intensive care unit

Kane‐Gill¹,

Visweswaran²,

Saul³

et al. 2011

International Journal of Medical Informatics

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Objective Clinical event monitors are a type of active medication monitoring system that can use signals to alert clinicians to possible adverse drug reactions. The primary goal was to evaluate the positive predictive values of select signals used to automate the detection of ADRs in the medical intensive care unit. Method This is a prospective, case series of adult patients in the medical intensive care unit during a six-week period who had one of five signals presents: an elevated blood urea nitrogen, vancomycin, or quinidine concentration, or a low sodium or glucose concentration. Alerts were assessed using 3 objective published adverse drug reaction determination instruments. An event was considered an adverse drug reaction when 2 out of 3 instruments had agreement of possible, probable or definite. Positive predictive values were calculated as the proportion of alerts that occurred, divided by the number of times that alerts occurred and adverse drug reactions were confirmed. Results 145 patients were eligible for evaluation. For the 48 patients (50% male) having an alert, the mean ± SD age was 62 ± 19 years. A total of 253 alerts were generated. Positive predictive values were 1.0, 0.55, 0.38 and 0.33 for vancomycin, glucose, sodium, and blood urea nitrogen, respectively. A quinidine alert was not generated during the evaluation. Conclusions Computerized clinical event monitoring systems should be considered when developing methods to detect adverse drug reactions as part of intensive care unit patient safety surveillance systems, since they can automate the detection of these events using signals that have good performance characteristics by processing commonly available laboratory and medication information.

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Section: Methodsmentioning

confidence: 99%

Computerized detection of adverse drug reactions in the medical intensive care unit

Kane‐Gill¹,

Visweswaran²,

Saul³

et al. 2011

International Journal of Medical Informatics

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“…Inappropriate medication use by adults living independently in the community has been reported to range from 12 to 40% (Zhan et al, 2001). Adverse drug events, defined as an injury due to an adverse drug reaction or a medication error (Silverman et al, 2004), directly account for 7,000 deaths each year (In-stitute of Medicine, 2000;Phillips et al, 1998). Nationwide, the average cost of medication-related problems and their associated conditions is over $2 billion annually and is expected to increase as more medications enter the marketplace with unknown interaction effects with existing prescription drugs (Institute of Medicine, 2000).…”

Section: The Need For Medication Managementmentioning

confidence: 99%

“…Prior research has evaluated the implementation of medication management processes using human (Gilbert et al, 2002) or technological (Glassman et al, 2002;Tamblyn et al, 2003) methods alone in multiple health care settings. However, the most powerful interventions appear to be those that incorporate human review with technology and evidence-based guidelines as decisional support mechanisms (Monane et al, 1998;Silverman et al, 2004). For older adults prescribed multiple drugs, medication review technology that assists health care providers with decisional support offers an effective and efficient means to address medication problems (Gurwitz et al, 2003).…”

Section: The Need For Medication Managementmentioning

confidence: 99%

Implications of Translating Research into Practice: A Medication Management Intervention

Alkema

Frey²

2006

Home Health Care Services Quarterly

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Through programs such as the Administration on Aging's Evidence-Based Prevention Initiative, researchers and practitioners are developing translational research studies seeking to implement rigorously tested, evidence-based interventions in new practice settings and evaluate the continuing effectiveness of these interventions. One such translational study is the Community-Based Medications Management Intervention (CBM Intervention), a collaborative effort to implement a medication management screening and intervention protocol in community-based waiver care management programs. The overall goals of the CBM Intervention are to implement an evidence-based medication management intervention in a California Medicaid waiver care management program, and to evaluate the effect of client-, intervention-, and organizational-level characteristics on resolving identified medication problems. This article presents the need for improved medication management in a frail, community-dwelling, older adult population and describes the CBM Intervention as an example of translating an evidence-based practice beyond its original efficacy trial in a home healthcare program into a care management program. It discusses critical factors involved in translating research into practice using a translational research framework, Promoting Action on Research Implementation in Health Services (PARIHS). Our experience suggests that although implementing research into practice can positively impact client care, professional skill enhancement and organizational effectiveness, this is very challenging work requiring signification facilitation for successful outcomes.

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“…De este modo, la implantació n de la prescripció n electró nica y la adició n de herramientas de ayuda a la prescripció n, que potencian notablemente su utilidad, han tenido suma relevancia a la hora de proporcionar un sistema seguro y coste efectivo para la promoció n del uso seguro de los medicamentos [16][17][18][19][20][21] .…”

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Bombas de infusión inteligentes: luces y sombras de una tecnología en desarrollo

et al. 2011

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Computer-based system for preventing adverse drug events

Cited by 32 publications

References 4 publications

Computerized detection of adverse drug reactions in the medical intensive care unit

Computerized detection of adverse drug reactions in the medical intensive care unit

Implications of Translating Research into Practice: A Medication Management Intervention

Bombas de infusión inteligentes: luces y sombras de una tecnología en desarrollo

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