Abstract
We developed a program to automatically screen patients' medication profiles for pairs of interacting drugs. Since some drug-drug interactions are indicated by changes in physiological parameters (e.g., ciprofloxacin and theophylline leading to an elevation of theophylline levels), the program considered the patients' relevant laboratory parameters prior to generating the alerts. We developed an editor to facilitate maintenance of the knowledge base. We evaluated the program for 3 weeks in two satellite pharmacies. The program reported 160 alerts of which 5 resulted in a change in the patients' therapies (one per 500 patient-days of care). These five interactions were potentially very serious. An additional 3 alerts led to changes in medication administration times. Subjectively, the program is well received and continues to be in routine clinical use.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Asch D. A., Parker R. M. The Libby Zion case. One step forward or two steps backward? N Engl J Med. 1988 Mar 24;318(12):771–775. doi: 10.1056/NEJM198803243181209. [DOI] [PubMed] [Google Scholar]
- Bates D. W., Leape L. L., Petrycki S. Incidence and preventability of adverse drug events in hospitalized adults. J Gen Intern Med. 1993 Jun;8(6):289–294. doi: 10.1007/BF02600138. [DOI] [PubMed] [Google Scholar]
- Evans R. S., Classen D. C., Stevens L. E., Pestotnik S. L., Gardner R. M., Lloyd J. F., Burke J. P. Using a hospital information system to assess the effects of adverse drug events. Proc Annu Symp Comput Appl Med Care. 1993:161–165. [PMC free article] [PubMed] [Google Scholar]
- Folli H. L., Poole R. L., Benitz W. E., Russo J. C. Medication error prevention by clinical pharmacists in two children's hospitals. Pediatrics. 1987 May;79(5):718–722. [PubMed] [Google Scholar]
- Leape L. L., Brennan T. A., Laird N., Lawthers A. G., Localio A. R., Barnes B. A., Hebert L., Newhouse J. P., Weiler P. C., Hiatt H. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med. 1991 Feb 7;324(6):377–384. doi: 10.1056/NEJM199102073240605. [DOI] [PubMed] [Google Scholar]
- Safran C., Slack W. V., Bleich H. L. Role of computing in patient care in two hospitals. MD Comput. 1989 May-Jun;6(3):141–148. [PubMed] [Google Scholar]
- Steel K., Gertman P. M., Crescenzi C., Anderson J. Iatrogenic illness on a general medical service at a university hospital. N Engl J Med. 1981 Mar 12;304(11):638–642. doi: 10.1056/NEJM198103123041104. [DOI] [PubMed] [Google Scholar]
- Teich J. M., Spurr C. D., Flammini S. J., Schmiz J., Beckley R. F., Hurley J. F., Aranow M., Glaser J. P. Response to a trial of physician-based inpatient order entry. Proc Annu Symp Comput Appl Med Care. 1993:316–320. [PMC free article] [PubMed] [Google Scholar]
- Wann L. S., Dillon J. C., Weyman A. E., Feigenbaum H. Echocardiography in bacterial endocarditis. N Engl J Med. 1976 Jul 15;295(3):135–139. doi: 10.1056/NEJM197607152950304. [DOI] [PubMed] [Google Scholar]