Implementation of a computer‐assisted monitoring system for the detection of adverse drug reactions in gastroenterology

Abstract

SUMMARYAim: To investigate the effectiveness of a computer monitoring system that detects adverse drug reactions (ADRs) by laboratory signals in gastroenterology. Methods: A prospective, 6-month, pharmacoepidemiological survey was carried out on a gastroenterological ward at the University Hospital Erlangen-Nuremberg. Two methods were used to identify ADRs. (i) All charts were reviewed daily by physicians and clinical pharmacists. (ii) A computer monitoring system generated a daily list of automatic laboratory signals and alerts of ADRs, including patient data and dates of events. Results: One hundred and nine ADRs were detected in 474 admissions (377 patients). The computer monitoring system generated 4454 automatic laboratory signals from 39 819 laboratory parameters tested, and issued 2328 alerts, 914 (39%) of which were associated with ADRs; 574 (25%) were associated with ADRpositive admissions. Of all the alerts generated, signals of hepatotoxicity (1255), followed by coagulation disorders (407) and haematological toxicity (207), were prevalent. Correspondingly, the prevailing ADRs were concerned with the metabolic and hepato-gastrointestinal system (61). The sensitivity was 91%: 69 of 76 ADR-positive patients were indicated by an alert. The specificity of alerts was increased from 23% to 76% after implementation of an automatic laboratory signal trend monitoring algorithm. Conclusion: This study shows that a computer monitoring system is a useful tool for the systematic and automated detection of ADRs in gastroenterological patients.

Automated detection of harm in healthcare with information technology: a systematic review

“…Only 14 studies15 17 18 20 22 23 26 30 32–34 44 47 48 compared an automated harm-detection method with ‘gold-standard’ adverse event detection and were eligible for critical appraisal of validity (table 2). Methodologies used to evaluate these automated systems were heterogeneous.…”

Incidence and cost estimate of treating pediatric adverse drug reactions in Lagos, Nigeria

“…Computerized prescribing and monitoring systems 39 have been adopted in developed countries to prevent ADRs, but may be too expensive to implement in Nigeria. However, less expensive methods like participation of pharmacists in ward rounds, 40 drug treatment monitoring, 41 and enhanced education and training in prescribing 42 can be implemented in Nigeria to reduce the burden of ADRs. Previous studies that looked into the estimated cost of ADRs in developed countries focused only on adult populations, and estimates were mainly based on the cost of hospitalizing the patients.…”

Terminologien oder Klassifikationen

“…Die Berücksichtigung von Labordaten (z. B. Kalium im Serum) ist weiterhin unerläss-lich für eine professionelle Arzneimitteltherapie [15,16].…”