The Impact of Customized Screening Intervals on the Burden of Drug-Drug Interaction Alerts: An Interrupted Time Series Analysis

Institute of Medicine Committee on Quality of Health Care in A. In: Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US) Copyright 2000 by the National Academy of Sciences. All rights reserved.; 2000.

Bates DW, Levine DM, Salmasian H, Syrowatka A, Shahian DM, Lipsitz S, et al. The Safety of Inpatient Health Care. N Engl J Med. 2023;388(2):142–53. PMID: 36630622. doi: https://doi.org/10.1056/NEJMsa2206117.

Article  PubMed  Google Scholar 

Krähenbühl-Melcher A, Schlienger R, Lampert M, Haschke M, Drewe J, Krähenbühl S. Drug-related problems in hospitals: a review of the recent literature. Drug Saf. 2007;30(5):379–407. PMID: 17472418. doi: https://doi.org/10.2165/00002018-200730050-00003.

Article  PubMed  Google Scholar 

Magro L, Moretti U, Leone R. Epidemiology and characteristics of adverse drug reactions caused by drug-drug interactions. Expert Opin Drug Saf. 2012;11(1):83–94. PMID: 22022824. doi: https://doi.org/10.1517/14740338.2012.631910.

Article  CAS  PubMed  Google Scholar 

Hennessy S, Leonard CE, Gagne JJ, Flory JH, Han X, Brensinger CM, et al. Pharmacoepidemiologic Methods for Studying the Health Effects of Drug-Drug Interactions. Clin Pharmacol Ther. 2016;99(1):92–100. PMID: 26479278. doi: https://doi.org/10.1002/cpt.277.

Article  CAS  PubMed  Google Scholar 

Vélez-Díaz-Pallarés M, Pérez-Menéndez-Conde C, Bermejo-Vicedo T. Systematic review of computerized prescriber order entry and clinical decision support. Am J Health Syst Pharm. 2018;75(23):1909–21. PMID: 30463867. doi: https://doi.org/10.2146/ajhp170870.

Article  PubMed  Google Scholar 

Roumeliotis N, Sniderman J, Adams-Webber T, Addo N, Anand V, Rochon P, et al. Effect of Electronic Prescribing Strategies on Medication Error and Harm in Hospital: a Systematic Review and Meta-analysis. J Gen Intern Med. 2019;34(10):2210-23. PMID: 31396810. doi: https://doi.org/10.1007/s11606-019-05236-8.

Kwan JL, Lo L, Ferguson J, Goldberg H, Diaz-Martinez JP, Tomlinson G, et al. Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials. Bmj. 2020;370:m3216. PMID: 32943437. doi: https://doi.org/10.1136/bmj.m3216.

Nabovati E, Vakili-Arki H, Taherzadeh Z, Saberi MR, Medlock S, Abu-Hanna A, et al. Information Technology-Based Interventions to Improve Drug-Drug Interaction Outcomes: A Systematic Review on Features and Effects. J Med Syst. 2017;41(1):12. PMID: 27889873. doi: https://doi.org/10.1007/s10916-016-0649-4.

van der Sijs H, Aarts J, Vulto A, Berg M. Overriding of drug safety alerts in computerized physician order entry. J Am Med Inform Assoc. 2006 Mar-Apr;13(2):138–47. PMID: 16357358. doi: https://doi.org/10.1197/jamia.M1809.

Article  PubMed  PubMed Central  Google Scholar 

Genco EK, Forster JE, Flaten H, Goss F, Heard KJ, Hoppe J, et al. Clinically Inconsequential Alerts: The Characteristics of Opioid Drug Alerts and Their Utility in Preventing Adverse Drug Events in the Emergency Department. Ann Emerg Med. 2016;67(2):240-8.e3. PMID: 26553282. doi: https://doi.org/10.1016/j.annemergmed.2015.09.020.

Villa Zapata L, Subbian V, Boyce RD, Hansten PD, Horn JR, Gephart SM, et al. Overriding Drug-Drug Interaction Alerts in Clinical Decision Support Systems: A Scoping Review. Stud Health Technol Inform. 2022;290:380–4. PMID: 35673040. doi: https://doi.org/10.3233/shti220101.

Article  PubMed  Google Scholar 

Van De Sijpe G, Quintens C, Walgraeve K, Van Laer E, Penny J, De Vlieger G, et al. Overall performance of a drug-drug interaction clinical decision support system: quantitative evaluation and end-user survey. BMC Med Inform Decis Mak. 2022;22(1):48. PMID: 35193547. doi: https://doi.org/10.1186/s12911-022-01783-z.

Tolley CL, Slight SP, Husband AK, Watson N, Bates DW. Improving medication-related clinical decision support. Am J Health Syst Pharm. 2018;75(4):239–46. PMID: 29436470. doi: https://doi.org/10.2146/ajhp160830.

Article  PubMed  Google Scholar 

Shah SN, Seger DL, Fiskio JM, Horn JR, Bates DW. Comparison of Medication Alerts from Two Commercial Applications in the USA. Drug Saf. 2021;44(6):661–8. PMID: 33616888. doi: https://doi.org/10.1007/s40264-021-01048-0.

Article  PubMed  PubMed Central  Google Scholar 

Chou E, Boyce RD, Balkan B, Subbian V, Romero A, Hansten PD, et al. Designing and evaluating contextualized drug-drug interaction algorithms. JAMIA Open. 2021;4(1):ooab023. PMID: 33763631. doi: https://doi.org/10.1093/jamiaopen/ooab023.

Horn J, Ueng S. The Effect of Patient-Specific Drug-Drug Interaction Alerting on the Frequency of Alerts: A Pilot Study. Ann Pharmacother. 2019;53(11):1087–92. PMID: 31296026. doi: https://doi.org/10.1177/1060028019863419.

Article  CAS  PubMed  Google Scholar 

Ledger TS, Brooke-Cowden K, Coiera E. Post-implementation optimization of medication alerts in hospital computerized provider order entry systems: a scoping review. J Am Med Inform Assoc. 2023;30(12):2064-71. PMID: 37812769. doi: https://doi.org/10.1093/jamia/ocad193.

Mille F, Schwartz C, Brion F, Fontan JE, Bourdon O, Degoulet P, et al. Analysis of overridden alerts in a drug-drug interaction detection system. Int J Qual Health Care. 2008;20(6):400-5. PMID: 18784269. doi: https://doi.org/10.1093/intqhc/mzn038.

Bhakta SB, Colavecchia AC, Haines L, Varkey D, Garey KW. A systematic approach to optimize electronic health record medication alerts in a health system. Am J Health Syst Pharm. 2019;76(8):530–6. PMID: 31361861. doi: https://doi.org/10.1093/ajhp/zxz012.

Article  PubMed  Google Scholar 

Helmons PJ, Suijkerbuijk BO, Nannan Panday PV, Kosterink JG. Drug-drug interaction checking assisted by clinical decision support: a return on investment analysis. J Am Med Inform Assoc. 2015;22(4):764–72. PMID: 25670751. doi: https://doi.org/10.1093/jamia/ocu010.

Article  PubMed  Google Scholar 

Askari M, Eslami S, Louws M, Wierenga PC, Dongelmans DA, Kuiper RA, et al. Frequency and nature of drug-drug interactions in the intensive care unit. Pharmacoepidemiology and Drug Safety. 2013 2013/04/01;22(4):430–7. doi: https://doi.org/10.1002/pds.3415.

Article  PubMed  Google Scholar 

Kiesel LM, Bertsche A, Kiess W, Siekmeyer M, Bertsche T, Neininger MP. Drug–Drug Interactions Involving High-Alert Medications that Lead to Interaction-Associated Symptoms in Pediatric Intensive Care Patients: A Retrospective Study. Pediatric Drugs. 2024 2024/07/04. doi: https://doi.org/10.1007/s40272-024-00641-x.

Bakker T, Abu-Hanna A, Dongelmans DA, Vermeijden WJ, Bosman RJ, de Lange DW, et al. Clinically relevant potential drug-drug interactions in intensive care patients: A large retrospective observational multicenter study. Journal of Critical Care. 2021 2021/04/01/;62:124 – 30. doi: https://doi.org/10.1016/j.jcrc.2020.11.020.

Wasylewicz ATM, van de Burgt BWM, Manten T, Kerskes M, Compagner WN, Korsten EHM, et al. Contextualized Drug-Drug Interaction Management Improves Clinical Utility Compared With Basic Drug-Drug Interaction Management in Hospitalized Patients. Clin Pharmacol Ther. 2022;112(2):382–90. PMID: 35486411. doi: https://doi.org/10.1002/cpt.2624.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Muylle KM, Gentens K, Dupont AG, Cornu P. Evaluation of an optimized context-aware clinical decision support system for drug-drug interaction screening. Int J Med Inform. 2021;148:104393. PMID: 33486355. doi: https://doi.org/10.1016/j.ijmedinf.2021.104393.

Resetar E, Reichley RM, Noirot LA, Dunagan WC, Bailey TC, editors. Customizing a commercial rule base for detecting drug-drug interactions. 2005: American Medical Informatics Association.

Reese T, Wright A, Liu S, Boyce R, Romero A, Del Fiol G, et al. Improving the specificity of drug-drug interaction alerts: Can it be done? Am J Health Syst Pharm. 2022;79(13):1086-95. PMID: 35136935. doi: https://doi.org/10.1093/ajhp/zxac045.

Seidling HM, Klein U, Schaier M, Czock D, Theile D, Pruszydlo MG, et al. What, if all alerts were specific - estimating the potential impact on drug interaction alert burden. Int J Med Inform. 2014;83(4):285–91. PMID: 24484781. doi: https://doi.org/10.1016/j.ijmedinf.2013.12.006.

Article  PubMed  Google Scholar 

Bakker T, Klopotowska JE, Dongelmans DA, Eslami S, Vermeijden WJ, Hendriks S, et al. The effect of computerised decision support alerts tailored to intensive care on the administration of high-risk drug combinations, and their monitoring: a cluster randomised stepped-wedge trial. The Lancet. 2024 2024/01/20/. doi: https://doi.org/10.1016/S0140-6736(23)02465-0.

Quintens C, De Rijdt T, Van Nieuwenhuyse T, Simoens S, Peetermans WE, Van den Bosch B, et al. Development and implementation of “Check of Medication Appropriateness” (CMA): advanced pharmacotherapy-related clinical rules to support medication surveillance. BMC Med Inform Decis Mak. 2019;19(1):29. PMID: 30744674. doi: https://doi.org/10.1186/s12911-019-0748-5.

Quintens C, Van de Sijpe G, Van der Linden L, Spriet I. Computerised prescribing support still needs a human touch. Age and Ageing. 2020. doi: https://doi.org/10.1093/ageing/afaa200.

Article  Google Scholar 

Quintens C, Peetermans WE, Lagrou K, Declercq P, Schuermans A, Debaveye Y, et al. The effectiveness of Check of Medication Appropriateness for antimicrobial stewardship: an interrupted time series analysis. J Antimicrob Chemother. 2021 Oct 7. PMID: 34618025. doi: https://doi.org/10.1093/jac/dkab364.

Quintens C, Verhamme P, Vanassche T, Vandenbriele C, Van den Bosch B, Peetermans WE, et al. Improving appropriate use of anticoagulants in hospitalised patients: A pharmacist-led Check of Medication Appropriateness intervention. Br J Clin Pharmacol. 2022;88(6):2959–68. PMID: 34913184. doi: https://doi.org/10.1111/bcp.15184.

Article  PubMed  Google Scholar 

Quintens C, De Coster J, Van der Linden L, Morlion B, Nijns E, Van den Bosch B, et al. Impact of Check of Medication Appropriateness (CMA) in optimizing analgesic prescribing: An interrupted time series analysis. Eur J Pain. 2021;25(3):704–13. PMID: 33259703. doi: https://doi.org/10.1002/ejp.1705.

Article  PubMed  Google Scholar 

Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D. Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Ther. 2002;27(4):299–309. PMID: 12174032. doi: https://doi.org/10.1046/j.1365-2710.2002.00430.x.

Article  CAS  PubMed  Google Scholar 

Kane-Gill SL, O’Connor MF, Rothschild JM, Selby NM, McLean B, Bonafide CP, et al. Technologic Distractions (Part 1): Summary of Approaches to Manage Alert Quantity With Intent to Reduce Alert Fatigue and Suggestions for Alert Fatigue Metrics. Critical Care Medicine. 2017;45(9).

Payne TH, Hines LE, Chan RC, Hartman S, Kapusnik-Uner J, Russ AL, et al. Recommendations to improve the usability of drug-drug interaction clinical decision support alerts. J Am Med Inform Assoc. 2015;22(6):1243–50. PMID: 25829460. doi: https://doi.org/10.1093/jamia/ocv011.

Article  PubMed  Google Scholar 

Edrees H, Amato MG, Wong A, Seger DL, Bates DW. High-priority drug-drug interaction clinical decision support overrides in a newly implemented commercial computerized provider order-entry system: Override appropriateness and adverse drug events. J Am Med Inform Assoc. 2020;27(6):893–900. PMID: 32337561. doi: https://doi.org/10.1093/jamia/ocaa034.

Article  PubMed  PubMed Central  Google Scholar 

Wong A, Amato MG, Seger DL, Rehr C, Wright A, Slight SP, et al. Prospective evaluation of medication-related clinical decision support over-rides in the intensive care unit. BMJ Qual Saf. 2018;27(9):718–24. PMID: 29440481. doi: https://doi.org/10.1136/bmjqs-2017-007531.

Article  PubMed  Google Scholar 

Amaral ACK-B, Cuthbertson BH. The efficiency of computerised clinical decision support systems. The Lancet. doi: https://doi.org/10.1016/S0140-6736(23)02839-8.

Vandael E, Vandenberk B, Vandenberghe J, Van den Bosch B, Willems R, Foulon V. A smart algorithm for the prevention and risk management of QTc prolongation based on the optimized RISQ-PATH model. Br J Clin Pharmacol. 2018;84(12):2824–35. PMID: 30112769. doi: https://doi.org/10.1111/bcp.13740.

Article  PubMed  PubMed Central  Google Scholar 

Eppenga WL, Derijks HJ, Conemans JM, Hermens WA, Wensing M, De Smet PA. Comparison of a basic and an advanced pharmacotherapy-related clinical decision support system in a hospital care setting in the Netherlands. J Am Med Inform Assoc. 2012 Jan-Feb;19(1):66–71. PMID: 21890873. doi: https://doi.org/10.1136/amiajnl-2011-000360.

Article 

Comments (0)

No login
gif