Clinical decision-making support systema in renal failure
| Autor: | E. Martínez Bernabé, G. Paluzie-Ávila, S. Terre Ohme, D. Ruiz Poza, M. A. Parada Aradilla, J. González Martínez, R. Albertí Valmaña, M. Castellvi Gordo |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | Farmacia Hospitalaria, Vol 38, Iss 3, Pp 216-222 (2014) |
| ISSN: | 2171-8695 1130-6343 |
| Popis: | Introduction: Support systems in clinical decision-making use individual characteristicsof the patient to generate recommendations to the clinician. Objective: To assess the impact of a tool for adjusting drug dosing in renal failure asa support system in clinical decision-making regarding the level of acceptance of theinterventions as well as the time invested by the pharmacist. Method: Non-randomized, prospective and hospital interventional study comparingpre- and post-implementation phases of an automated renal function alert system, carriedout at two county hospitals. Forty drugs were monitored before the intervention(2007). The blood work of the patients receiving any of these drugs was reviewed. Incase of impaired renal function, an adjustment recommendation was inserted in themedical prescription. If the physician accepted it, it was rated as success. The averagetime was 1 minute per blood work reviewed and 3 minutes per recommendation. Anautomated adjustment recommendation system according to renal function with alertpop-ups was implemented in 2008 for 100 drugs. Later (2009), the number of interventionsand the success rate for this tool were assessed and compared. Results: Pre-implementation phase. 28,234 electronic medical prescriptions correspondingto a mean number of 205 hospitalized patients/day were validated and 4,035 bloodworks were reviewed. One hundred and twenty-one pharmaceutical interventions(0.43% of the medical prescriptions) were inserted. A success rate of 33.06% of theinterventions was obtained. The time invested by the pharmacist for consulting the bloodworks and making the recommendations was 73.3 hours (67.25 hours correspondingto patients without renal function impairment and in whom no intervention was made).Post-implementation phase. 26,584 electronic medical orders corresponding to 193 hospitalizedpatients/day were validated and 1,737 automated interventions were performed(6.53% of total medical orders), of which 65.69% were accepted (success). Conclusions: The implementation of clinical decision-making support systems allowsextending the number of patients and drugs monitored, optimizing the time investedby the pharmacist. Simultaneous occurrence of an alert during prescription may havecontributed to the greater success rate observed. |
| Databáze: | OpenAIRE |
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