Enhancing pharmaceutical decision support system: evaluating antithrombotic-focused algorithms for addressing...

Area of Science:

• Clinical Pharmacy
• Health Informatics
• Pharmacology

Background:

• Pharmaceutical decision support systems (PDSS) aid in managing complex medication regimens.
• Antithrombotic agents require careful monitoring due to their narrow therapeutic index and bleeding risk.
• Drug-related problems (DRPs) associated with antithrombotics can lead to significant patient harm.

Purpose of the Study:

• To assess the effectiveness of antithrombotic-focused pharmaceutical algorithms (PAs) within a PDSS.
• To determine the impact of these PAs on detecting DRPs and facilitating pharmaceutical interventions.

Main Methods:

• A prospective observational study was conducted in two health facilities from November 2019 to June 2023.
• 26 antithrombotic-specific PAs were developed and compared to the broader PDSS.
• Pharmacists reviewed system-generated alerts, documented interventions, and physician acceptance rates.

Main Results:

• Antithrombotic PAs identified a substantial proportion of DRPs detected by the PDSS.
• Pharmacists issued 1170 interventions for antithrombotic alerts, with 57.8% accepted by physicians.
• The overall PDSS, including other PAs, resulted in 3341 interventions with a 53.4% acceptance rate.

Conclusions:

• Tailored PAs for antithrombotics significantly contribute to DRP detection.
• Integrating specific algorithms into PDSS enhances pharmaceutical interventions and patient safety.
• PDSS should incorporate antithrombotic-focused algorithms to adapt to patient needs and complement care.