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Pharmacy department
Configuring drug : drug
interactions – don’t
assume….
Anna BunchIM&T and ePrescribing Pharmacist Lead
15th October 2014
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Pharmacy department
Decision Support
Clinical decision support (CDS):
providing clinicians or patients with clinical
knowledge and patient-related information,
intelligently filtered and presented at appropriate
times can improve the safety, quality, efficiency,
and cost-effectiveness of care when applied to
ePrescribing (ePMA) systemsAmerican Medical Informatics Association, White Paper,2005
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Pharmacy department
Types Of Clinical Decision support
• Drug – Drug Interaction
• Therapeutic duplication
• Drug – Allergy interaction
• Drug – Co-morbidity interaction
• Dose Range checking
• Therapeutic drug monitoring
• Sensitivity Checking
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Pharmacy department
Types of Clinical decision support
available
• Build your own– Meditech
• System Provided– PICS
–Ascribe
•Third party systems–FDB (JAC, CSC)
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Pharmacy department
Dependents
• Data Reference Source– recognised alerts
• Available data to cross check– allergies
– Patient age
– co-morbidities etc
• Up-date frequency– monthly,
– new drugs & trial drugs
• Configurability / Local demands
• Retrospective checking
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Pharmacy department
ALERTALERT
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Pharmacy department
Alert fatigue
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Pharmacy department
Conflict Log
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Pharmacy department
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Pharmacy department
Configuration
• Trust Specific
• Linked to Guidelines
• Ability to turn off
• Ability to add (clinical Trials)
• Therapeutic duplications
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Pharmacy department
UHS Configuration
• Duplicates– Morphine IV/Oral
• Interaction Levels– Level 1-4
– Can be set per user type i.e. Pharmacist, Junior Doctor
– No defined list per level
• Suppressed interactions
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Pharmacy department
Interaction set-up
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Pharmacy department
•4 Star: Risk is high and outweighs possible benefit.
Do not combine.
•3 Star: Risk is significant. Combine in special
circumstances only having considered the risk to
benefit ratio for the patient.
•2 Star: Risk is moderate. Combine with caution
having considered the risk to benefit ratio for the
patient.
•1 Star: Risk is low. Combine having considered the
risk to benefit ratio for the patient.
NB: FDB state there is a degree of clinical judgement that
goes into assigning them.
Interaction severity levels
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Pharmacy department
Conflict Log
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Pharmacy department
Available Clinical Information
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Pharmacy department
Drug Chart View
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Pharmacy department
Thank you
[email protected] Department
Southampton General Hospital
Tremona Road
Southampton
SO16 6YD
Tel 02381 204190