Effect of Clinical Decision Support System and Clinical Pharmacists’ Practice in Preventing Drug-drug Interactions among Inpatients in Bac Ninh General Hospital

Nguyen Thanh Hai, Pham Thi Thuy Van, Ly Cong Thanh, Luong Thi Lap, Can Khanh Linh, Nguyen Xuan Bach
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Abstract

Drug-drug interaction is one of the drug-related problems that can reduce therapeutic efficacy or increase the risk of undesirable effects. Subjects and methods: interventional study design with before-after comparison. In the pre-intervention period, we retrospectively carried out all electronic prescriptions and medical records of inpatients treated from 01/11/2021 to 31/01/2022. In the post-intervention period, we prospectively performed monitoring reports on the drug-drug interaction warning system and medical records of inpatients from 01/02/2022 to 31/03/2022. Results: The proportion of patients exposed to drug-drug interactions (DDIs) decreased significantly from 4.27% in the pre-intervention period to 3.56% in the post-intervention period (p<0.05). There were no medical records with contraindicated DDIs in the post-intervention period. The percentage of patients for contraindication DDIs with conditions determined to patients with the condition was 39.33% and 27.59%, respectively, in the pre-and post-intervention phases. Medical records rate with major DDIs decreased significantly in the post-intervention period (2.95% vs 3.68%; p<0.05). Conclusion: Clinical decision support systems with drug-drug interaction warnings and clinical pharmacy activities help to reduce the frequency of DDIs. The results show that the combination of these two measures initially brings about effective DDIs management in hospitals.
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北宁总医院临床决策支持系统与临床药师在预防住院患者药物-药物相互作用中的作用
药物-药物相互作用是药物相关问题之一,可降低治疗效果或增加不良反应的风险。研究对象和方法:介入研究设计,前后比较。在干预前,我们回顾性分析了2021年11月1日至2022年1月31日住院患者的所有电子处方和病历。干预后,我们前瞻性地对2022年2月1日至2022年3月31日住院患者的药物-药物相互作用预警系统和病历进行监测报告。结果:出现药物-药物相互作用(ddi)的患者比例由干预前的4.27%下降至干预后的3.56% (p < 0.05)。干预后无ddi禁忌的医疗记录。在干预前和干预后两阶段,确定病情的患者使用禁忌症ddi的比例分别为39.33%和27.59%。重度ddi患者的医疗记录率在干预后显著下降(2.95% vs 3.68%;术中,0.05)。结论:具有药物相互作用警示和临床药学活动的临床决策支持系统有助于减少ddi的发生。结果表明,这两种措施的结合初步实现了医院ddi管理的有效实施。
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