ISSN: 1859 - 2872
Impact of clinical decision support systems of drug dosage in inpatients with renal failure in Yen Phong General Hospital
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Abstract
Objective: To analyze the impact of a clinical decision support system for drug dosage in inpatients with renal failure in Yen Phong general hospital. Subject and method: before-after study. Phase 1: retrospective study on medical records of inpatients treated at Yen Phong Medical Center from October 2020 to December 2020. Phase 2: Prospective study on medical records after implementing CDSS integration and clinical pharmacist’ interventions from 01/2022 đến tháng 03/2022. Result: Phase 1, there were 186 out of 401 medical records needed dose adjustment. The number of drugs whose doses needed to be adjusted is 280 out of 2531. There were 107 times of inappropriate dosages, accounting for 38.2%; and the proportion of patients having inappropriate dose adjustment was 41.4%. The most frequent drugs prescribed with inappropriate doses according to the renal function were colchicin, spironolacton, pregabalin, piroxicam and aspirin. Phase 2: 310 alerts appeared in 50 patients and the proportion of alert cancellation was 4.5%. CDSS combined with clinical pharmacy activities reduced the rate of medication turns and the proportion of patients with inappropriate dose adjustment down to 19.7% and 28.0%, respectively. The 5 drugs with the most alerts are spironolacton, levofloxacin, bambuterol, cefamandol and rivaroxaban. Conclusion: CDSS combined with clinical pharmacy activity helps to reduce the rate of drug administration and patients with renal impairment who receive inappropriate dose adjustment.
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References
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