Potential drug-related problems detected by electronic expert support system: physicians’ views on clinical relevance

Hammar, Tora; Lidström, Bodil; Petersson, Göran; Gustafson, Yngve; Eiermann, Birgit

doi:10.1007/s11096-015-0146-8

Cited by 25 publications

(30 citation statements)

References 45 publications

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“…Some of the alerts may already have been resolved or evaluated by the healthcare services without the pharmacists knowing about this, and there is a risk that patients receive contradicting information from the pharmacist. A previous study among physicians showed that they regarded 68% of EES alerts to be clinically relevant, and 11% of all alerts were followed by a change in drug treatment [ 26 ]. In our study, contact with the prescriber and change of prescription was documented for only 0.2% of all closed alerts.…”

Section: Discussionmentioning

confidence: 99%

“…EES is not available to prescribers in Swedish health care. Previous studies have described the potential DRPs detected by EES in patients with multi-dose drug dispensing and have shown that physicians regard the majority of alerts as clinically relevant [ 25 , 26 ]. Although EES has been available at pharmacies for many years, its use has been low and only studied in a few small studies where most of them are not published scientifically [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

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The Use of a Decision Support System in Swedish Pharmacies to Identify Potential Drug-Related Problems—Effects of a National Intervention Focused on Reviewing Elderly Patients’ Prescriptions

Hammar

Hellström

Ericson³

2020

Pharmacy

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In pharmacies in Sweden, a clinical decision support system called Electronic Expert Support (EES) is available to analyse patients’ prescriptions for potential drug-related problems. A nationwide intervention was performed in 2018 among all Swedish pharmacy chains to increase the use of EES among patients 75 years or older. The aim of this research was to study the use of EES in connection with the national intervention in order to describe any effects of the intervention, to understand how pharmacists use EES and to identify any barriers and facilitators for the use of EES by pharmacists for elderly patients. Data on the number and categories of EES analyses, alerts, resolved alerts and active pharmacies was provided by the Swedish eHealth Agency. The effects of the intervention were analysed using interrupted time series regression. A web-based questionnaire comprising 20 questions was sent to 1500 pharmacists randomly selected from all pharmacies in Sweden. The study shows that pharmacists use and appreciate EES and that the national intervention had a clear effect during the week of the intervention and seems to have contributed to a faster increase in pharmacists’ use of EES during the year to follow. The study also identified several issues or barriers for using EES.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Use of a Decision Support System in Swedish Pharmacies to Identify Potential Drug-Related Problems—Effects of a National Intervention Focused on Reviewing Elderly Patients’ Prescriptions

Hammar

Hellström

Ericson³

2020

Pharmacy

Self Cite

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“…However, as previously described this limitation reflects the working methods used by clinical pharmacists in Norway at the time, in which medicines reconciliation was not included. (155,195).…”

Section: Discussion Of Methodologymentioning

confidence: 99%

Severity and Management of Drug–Drug Interactions in Acute Geriatric Patients

Lea¹,

Rognan

Koristovic

et al. 2013

Drugs Aging

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“…17 Several systems have been proposed for the classification of DRP, with the Pharmaceutical Care Network Europe (PCNE) being one of the most commonly used classification systems in hospital practice. 18 Several DRP detection strategies have been developed, including pharmacist review of medication orders (MO), the use of computerised physician order entry (CPOE) systems couple with clinical decision support programs [19][20][21] that allow the clinical pharmacist to have an active participation within the healthcare team. 5 8 22-24 However, despite the clinical and economic relevance of DRP, very few studies have investigated the incidence, types and causes of DRP in patients hospitalised in general medical and surgical wards.…”

Section: Introductionmentioning

confidence: 99%

Incidence, types and acceptability of pharmaceutical interventions about drug related problems in a general hospital: an open prospective cohort

et al. 2020

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ObjectivesTo evaluate the incidence and types of drug-related problems (DRP) in a general teaching hospital and to evaluate the acceptability of pharmaceutical interventions by the medical team.DesignProspective cohort study during 2 years.SettingConducted in a Brazilian University Hospital.ParticipantsThe patient cohort consisted of 9303 patients with a total of 12 286 hospitalisation episodes.Primary outcome measuresDRP detected by pharmacists’ review of 100% medication orders using Pharmaceutical Care Network Europe 6.2 classification.ResultsPatients with a mean age of 52.6±17.7 years and 50.9% females. A total of 3373 DRP in 1903 hospital episodes were identified, corresponding to a cumulative incidence of 15.5%. ‘Treatment ineffectiveness’ (11.5%) and ‘Treatment costs’ (5.90%) were the most common DRP and ‘Drug use process’ (18.4%) and ‘Treatment duration’ (31.0%) the main causes of DRP. The medicines involved most often involved in DRP were anti-infectives (36.0%), mainly cephalosporins (20.2%), antiulcer (38.6%), analgesics/antipyretics (61.2%), propulsives (51.2%), opioids (38.5%) and antiemetics (57.4%). From 1939 pharmaceutical interventions, at least, 21.4% were not approved by the medical team.ConclusionDRP detected by 100% medication order review by hospital pharmacists occur in a significant proportion of hospital episodes, the most frequent being related to treatment effectiveness and treatment costs. The medications mostly involved were cephalosporins, penicillins, antidyspeptics, analgesics, antipyretics, opioids and antiemetics. Pharmaceutical interventions had low acceptability by the medical staff.

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Potential drug-related problems detected by electronic expert support system: physicians’ views on clinical relevance

Abstract: In most patients with multi-dose drug dispensing, EES detected potential drug-related problems, with the majority of the alerts regarded as clinically relevant and some followed by measurable changes in drug treatment.

Cited by 25 publications

References 45 publications

The Use of a Decision Support System in Swedish Pharmacies to Identify Potential Drug-Related Problems—Effects of a National Intervention Focused on Reviewing Elderly Patients’ Prescriptions

The Use of a Decision Support System in Swedish Pharmacies to Identify Potential Drug-Related Problems—Effects of a National Intervention Focused on Reviewing Elderly Patients’ Prescriptions

Severity and Management of Drug–Drug Interactions in Acute Geriatric Patients

Incidence, types and acceptability of pharmaceutical interventions about drug related problems in a general hospital: an open prospective cohort

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