Tinka Bakker1, Joanna E Klopotowska2, Nicolette F de Keizer3, Rob van Marum4, Heleen van der Sijs5, Dylan W de Lange6, Evert de Jonge7, Ameen Abu-Hanna8, Dave A Dongelmans9. 1. Amsterdam UMC (location AMC), Department of Medical Informatics, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: t.bakker1@amsterdamumc.nl. 2. Amsterdam UMC (location AMC), Department of Medical Informatics, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: j.e.klopotowska@amsterdamumc.nl. 3. Amsterdam UMC (location AMC), Department of Medical Informatics, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: n.f.keizer@amsterdamumc.nl. 4. Department of Geriatrics, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ's-Hertogenbosch, The Netherlands; Amsterdam UMC (location VUmc), Department of General Practice and Elderly Care Medicine, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: r.v.marum@jbz.nl. 5. Department of Hospital Pharmacy, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. Electronic address: i.vandersijs@erasmusmc.nl. 6. Department of Intensive Care and Dutch Poison Information Center, University Medical Center Utrecht, University Utrecht, , Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.. Electronic address: d.w.delange@umcutrecht.nl. 7. Department of Intensive Care, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Electronic address: e.de_jonge@lumc.nl. 8. Amsterdam UMC (location AMC), Department of Medical Informatics, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: a.abu-hanna@amsterdamumc.nl. 9. Amsterdam UMC (location AMC), Department of Intensive Care Medicine, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: d.a.dongelmans@amsterdamumc.nl.
Abstract
PURPOSE: Drug-drug interactions (DDIs) may cause adverse outcomes in patients admitted to the Intensive Care Unit (ICU). Computerized decision support systems (CDSSs) may help prevent DDIs by timely showing relevant warning alerts, but knowledge on which DDIs are clinically relevant in the ICU setting is limited. Therefore, the purpose of this study was to identify DDIs relevant for the ICU. MATERIALS AND METHODS: We conducted a modified Delphi procedure with a Dutch multidisciplinary expert panel consisting of intensivists and hospital pharmacists to assess the clinical relevance of DDIs for the ICU. The procedure consisted of two rounds, each included a questionnaire followed by a live consensus meeting. RESULTS: In total the clinical relevance of 148 DDIs was assessed, of which agreement regarding the relevance was reached for 139 DDIs (94%). Of these 139 DDIs, 53 (38%) were considered not clinically relevant for the ICU setting. CONCLUSIONS: A list of clinically relevant DDIs for the ICU setting was established on a national level. The clinical value of CDSSs for medication safety could be improved by focusing on the identified clinically relevant DDIs, thereby avoiding alert fatigue.
PURPOSE: Drug-drug interactions (DDIs) may cause adverse outcomes in patients admitted to the Intensive Care Unit (ICU). Computerized decision support systems (CDSSs) may help prevent DDIs by timely showing relevant warning alerts, but knowledge on which DDIs are clinically relevant in the ICU setting is limited. Therefore, the purpose of this study was to identify DDIs relevant for the ICU. MATERIALS AND METHODS: We conducted a modified Delphi procedure with a Dutch multidisciplinary expert panel consisting of intensivists and hospital pharmacists to assess the clinical relevance of DDIs for the ICU. The procedure consisted of two rounds, each included a questionnaire followed by a live consensus meeting. RESULTS: In total the clinical relevance of 148 DDIs was assessed, of which agreement regarding the relevance was reached for 139 DDIs (94%). Of these 139 DDIs, 53 (38%) were considered not clinically relevant for the ICU setting. CONCLUSIONS: A list of clinically relevant DDIs for the ICU setting was established on a national level. The clinical value of CDSSs for medication safety could be improved by focusing on the identified clinically relevant DDIs, thereby avoiding alert fatigue.
Authors: Eric Chou; Richard D Boyce; Baran Balkan; Vignesh Subbian; Andrew Romero; Philip D Hansten; John R Horn; Sheila Gephart; Daniel C Malone Journal: JAMIA Open Date: 2021-03-19
Authors: Tinka Bakker; Dave A Dongelmans; Ehsan Nabovati; Saeid Eslami; Nicolette F de Keizer; Ameen Abu-Hanna; Joanna E Klopotowska Journal: J Clin Pharmacol Date: 2022-02-21 Impact factor: 2.860