Effect of Clinical Decision Support System on Dose Adjustments in Inpatients with Renal Failure at Thai Binh Medical University Hospital

Abstract

Objective: The study aimed to evaluate the effectiveness of the Clinical Decision Support System (CDSS) in dosage adjustment for inpatients with renal impairment at Thai Binh University Hospital. Subjects and methods: Medical records of inpatients treated at Thai Binh University Hospital were reviewed during the periods from 01/01/2022 to 30/11/2022 and from 01/12/2022 to 15/03/2023. Study design: a cross-sectional descriptive study. Results: Before the integration of CDSS, among 300 medical records, dose adjustment was required in 81.7% of medical records, which included 64.5% inappropriate dosage modification. There were 406 prescriptions requiring dose adjustment, accounting for 31.5% of the total prescriptions, and 52.7% of the total prescriptions had inappropriate dose adjustment. After the integration of CDSS, 320 alerts were recorded for 55 patients between December 1st, 2022, and March 15th, 2023. The alert cancellation proportion was 2.8%. Among the alerts that were overridden, 55.6% involved clinical pharmacist consultations. The combination of CDSS and clinical pharmacist consultations reduced the proportion of prescriptions and medical records having inappropriate dosage adjustments to 10.6% and 16.4%, respectively. Conclusion: CDSS had positive impacts on dosage adjustments in inpatients with renal insufficiency at Thai Binh Medical University Hospital.