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NP-011 Mediscreen: implementation of a tool for detecting patients at risk of adverse drug events via the electronic medical record
  1. A-V Luyet1,
  2. V Jordan-von Gunten1,
  3. P Turini2,
  4. J Beney1
  1. 1Division of Pharmacy, Institut Central des Hôpitaux (ICH), Hôpital du Valais (HVS), Sion, Switzerland
  2. 2Medical Coordinator for quality of care and patient safety, Hôpital du Valais (HVS), Sion, Switzerland


Background Pharmacists at our hospital are not able to validate all prescriptions daily. To fill this gap, a project called MediScreen was launched to detect situations at risk of drug-related problems (SRDRP). Twenty-five queries of high criticality were developed based on a literature review and consensus with physicians from different medical disciplines. The queries were then programmed with the software PharmaClass, which is interfaced with the electronic medical record of our hospital.

Purpose The aims of this study were to evaluate the impact of this screening on drug therapy and to estimate the time required for pharmacists to analyse and manage SRDRP.

Material and methods PharmaClass performed a real-time detection of all hospitalised patients (approximately 900 beds) in whom SRDRP occurs. During 6 months (February–July 2018), the clinical pharmacist analysed the detected SRDRP and, if necessary, called the prescriber to suggest treatment modifications. The following indicators were measured: number of SRDRP detected, pharmacist interventions accepted by the physician (and acceptance rate), refused (R) or not applicable (NA). The required resources were quantified in pharmacist-time per day.

Results After elimination of false positives due to interfacing problems, of 986 SRDRP, 808 (82%) were not clinically relevant, 50 (5%) were resolved before pharmacist intervention and 128 (13%) were addressed. One-hundred and four (87%) proposals were accepted and implemented (16 R and eight NA). On average, pharmacists spent 1 hour 20 min per day on the analysis of about 10 SRDRP (9.8) and intervened about once a day (0.85).

Conclusion MediScreen allowed us to adapt treatment and prevent the occurrence of adverse drug events in 104 situations that would not otherwise have been identified. This new activity required a reassignment of time spent on clinical activities. For some queries (to identify a particular drug-related problem), the specificity should be improved to reduce the rate of non-clinically relevant SRDRP. For those identifying a specific drug at risk, sensitivity is a more appropriate endpoint than specificity. The focus on queries of high criticality and the pharmacist’s verification of the clinical relevance of SRDRP contribute to the high acceptance rate (87%). After this first step with a limited number of queries, alerts for less critical situations will be developed in order to optimise the treatment of patients seen during interdisciplinary visits.

References and/or acknowledgements None.

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