Drug-drug interaction checking assisted by clinical decision support: a return on investment analysis

Area of Science:

• Pharmacology
• Health Informatics
• Clinical Pharmacy

Background:

• Drug-drug interactions (DDIs) are a significant concern in hospitalized patients.
• Current DDI alert systems often generate clinically irrelevant alerts, leading to alert fatigue.

Purpose of the Study:

• To evaluate the impact of suppressing irrelevant DDI alerts and implementing clinical-decision support systems (CDSS) on alert volume and pharmacist workload.
• To quantify the time saved and invested in optimizing DDI checking processes.

Main Methods:

• A multidisciplinary panel assessed the clinical relevance of frequent DDIs.
• Pharmacists utilized CDSS for evaluating relevant DDIs.
• Two phases were implemented: Phase 1 (CDSS-assisted checking) and Phase 2 (CDSS-assisted checking with irrelevant alerts suppressed).
• Alert numbers and pharmacist DDI checking duration were compared to conventional methods.

Main Results:

• CDSS implementation reduced daily DDI alerts by 27% in Phase 1 and 55% in Phase 2.
• Pharmacist DDI checking time decreased by 27% in Phase 1 and 45% in Phase 2.
• The system demonstrated an annual time saving of 30 hours, with a return on investment of approximately 9.8 years.

Conclusions:

• CDSS-assisted DDI checking, combined with suppression of irrelevant alerts, substantially improves efficiency.
• This strategy reduces alert burden and time spent on DDI review without increasing staff.
• The approach offers a scalable model for enhancing other drug safety modules.