Modelling and assessing one- and two-drug dose titrations.

Area of Science:

• Health Informatics
• Clinical Pharmacology
• Medical Error Quantification

Background:

• Medical errors, particularly wrong dose prescriptions, necessitate improved quantification methods in healthcare.
• Drug dose titration (DT) is a critical process for adjusting medication dosages to patient-specific needs, varying by disease, drug, and patient condition.
• Standardized modeling of DT procedures can enhance clinical decision-making, homogenization, and retrospective analysis.

Purpose of the Study:

• To propose a novel language for modeling diverse drug dose titration procedures.
• To formalize one- and two-drug titration protocols for chronic and acute conditions.
• To conduct retrospective analyses to identify deviations from standard DT methods in patient cohorts.

Main Methods:

• Development of a formal language to represent drug dose titration procedures.
• Formalization of single- and dual-drug titration for acute and chronic conditions.
• Retrospective analysis of DT processes in 253 diabetes mellitus type 2 patients (metformin), 321 chronic heart failure patients (furosemide), 155 hyperuricemia patients (allopurinol/febuxostat), and 187 hyperuricemia patients (allopurinol/probenecid).

Main Results:

• The proposed language successfully modeled various drug titration procedures.
• Retrospective analysis identified specific types of deviations from standard DT methods across the studied patient groups.
• The findings provide insights into real-world adherence to established drug titration protocols.

Conclusions:

• A new language effectively models drug dose titration, supporting standardization and analysis.
• The study highlights the occurrence of deviations from standard DT practices in clinical settings.
• This work contributes to better understanding and potentially reducing medication errors through improved DT process management.