Impact of a clinical decision support tool targeting QT-prolonging medications.
Am J Health Syst Pharm
; 77(Supplement_4): S111-S117, 2020 Nov 16.
Article
en En
| MEDLINE
| ID: mdl-32839818
ABSTRACT
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
Problema de salud:
1_doencas_nao_transmissiveis
/
2_muertes_prematuras_enfermedades_notrasmisibles
Asunto principal:
Pautas de la Práctica en Medicina
/
Síndrome de QT Prolongado
/
Sistemas de Apoyo a Decisiones Clínicas
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Health Syst Pharm
Asunto de la revista:
FARMACIA
/
HOSPITAIS
Año:
2020
Tipo del documento:
Article