The use of a clinical decision support tool to assess the risk of QT drug-drug interactions in community pharmacies

被引：6

作者：

Berger, Florine A. ^{[1
]}

van der Sijs, Heteen ^{[1
]}

van Gelder, Teun ^{[1
,2
]}

van den Bemt, Patricia M. L. A. ^{[1
,2
]}

机构：

[1] Erasmus MC, Dept Hosp Pharm, Doctor Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

[2] Leiden Univ, Dept Clin Pharm & Toxicol, Med Ctr, Leiden, Netherlands

来源：

THERAPEUTIC ADVANCES IN DRUG SAFETY | 2021年 / 12卷

关键词：

clinical decision support systems; community pharmacies; drug-drug interactions; intervention; primary care; INTERACTION ALERTS; DOUBLE-BLIND; PROLONGATION; SAFETY; HALOPERIDOL; DOMPERIDONE; MANAGEMENT; USABILITY; OVERRIDES; INTERVAL;

D O I：

10.1177/2042098621996098

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Introduction: The handling of drug-drug interactions regarding QTc-prolongation (QT-DDIs) is not well defined. A clinical decision support (CDS) tool will support risk management of QT-DDIs. Therefore, we studied the effect of a CDS tool on the proportion of QT-DDIs for which an intervention was considered by pharmacists. Methods: An intervention study was performed using a pre- and post-design in 20 community pharmacies in The Netherlands. All QT-DDIs that occurred during a before- and after-period of three months were included. The impact of the use of a CDS tool to support the handling of QT-DDIs was studied. For each QT-DDI, handling of the QT-DDI and patient characteristics were extracted from the pharmacy information system. Primary outcome was the proportion of QT-DDIs with an intervention. Secondary outcomes were the type of interventions and the time associated with handling QT-DDIs. Logistic regression analysis was used to analyse the primary outcome. Results: Two hundred and forty-four QT-DDIs pre-CDS tool and 157 QT-DDIs post-CDS tool were included. Pharmacists intervened in 43.0% and 35.7% of the QT-DDIs pre- and post-CDS tool respectively (odds ratio 0.74; 95% confidence interval 0.49-1.11). Substitution of interacting agents was the most frequent intervention. Pharmacists spent 20.8 +/- 3.5 min (mean +/- SD) on handling QT-DDIs pre-CDS tool, which was reduced to 14.9 +/- 2.4 min (mean +/- SD) post-CDS tool. Of these, 4.5 +/- 0.7 min (mean +/- SD) were spent on the CDS tool. Conclusion: The CDS tool might be a first step to developing a tool to manage QT-DDIs via a structured approach. Improvement of the tool is needed in order to increase its diagnostic value and reduce redundant QT-DDI alerts.

引用

页数：14

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