Impact of a clinical decision support tool targeting QT-prolonging medications
| Autor: | Carrie Hartner, Stephanie B. Edwin, Katie Chernoby, Michelle Dehoorne, Michael F. Lucey |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Michigan Patient risk Psychological intervention Torsades de pointes 030204 cardiovascular system & hematology QT interval Clinical decision support system Hospitals University 03 medical and health sciences 0302 clinical medicine Intervention (counseling) Medicine Humans In patient 030212 general & internal medicine Practice Patterns Physicians' Adverse effect Aged Retrospective Studies Pharmacology business.industry Health Policy medicine.disease Decision Support Systems Clinical Long QT Syndrome Emergency medicine Female business Pharmacy Service Hospital |
| Zdroj: | American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists. 77(Supplement_4) |
| ISSN: | 1535-2900 |
| Popis: | Purpose To evaluate the impact of a newly implemented clinical decision support (CDS) tool targeting QT interval–prolonging medications on order verification and provider interventions. Methods A multicenter, retrospective quasi-experimental study was conducted to evaluate provider response to CDS alerts triggered during ordering of QT-prolonging medications for adult patients. The primary outcome was the proportion of orders triggering QTc alerts that were continued without intervention during a specified preimplementation phase (n = 49) and during a postimplementation phase (n = 100). Patient risk factors for QTc prolongation, provider alert response, and interventions to reduce the risk of QTc-associated adverse events were evaluated. Results The rate of order continuation without intervention was 82% in the preimplementation phase and 37% in the postimplementation phase, representing an 55% reduction in continued verified orders following implementation of the QT-focused CDS tool. Most alerts were initially responded to by the prescriber, with pharmacist intervention needed in only 33% of cases. There were no significant differences in patient QTc-related risk factors between the 2 study groups (P = 0.11); the postimplementation group had a higher proportion of patients using at least 2 QTc-prolonging medications (48%, compared to 26% in the preimplementation group; P = 0.02). Conclusion Implementation of the CDS tool was associated with a reduction in the proportion of orders continued without intervention in patients at high risk for QTc-related adverse events. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
| Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |