Background and importance Anticoagulants are sources of iatrogenia when they are used, misused or not used, especially when medication errors are involved. The EAHP statement integrates pharmaceutical analysis into our practices mentioning that all prescriptions should be reviewed and validated as soon as possible by a pharmacist. Pharmaceutical analysis practice is highly variable. Clinical decision support systems have proven to be effective globally in reducing morbidity, improving the detection of drug related problems (DRP) and reducing adverse drug events and costs. The threefold alliance, AVICENNE, as a real time clinical decision support system, works on the patient’s data, pharmaceutical algorithms and Pharmaclass (Keenturtle-F).
Aim and objectives The aim of the study was present the ability of AVICENNE to detect DRP when working on anticoagulation therapy compared with other drugs.
Material and methods An observational prospective study has been ongoing from January 2019 to September 2020 in two facilities (1600 beds). 20 to about 135 pharmaceutical algorithms encoded in Pharmaclass detected patients with an anticoagulant related problem. Guidelines structured the pharmaceutical analysis of selected DRP analysed from anamnesis to transmission of the pharmaceutical interventions (PI). In the two algorithms, the number of accepted PIs were collected via computerised patient order entries.
Results The data were collected over 260 non-consecutive days. Of 4121 alerts 1301 were about anticoagulant medications (31%) and 2820 about other medications (69%). DRP detection was better with the algorithm on anticoagulants than with the other algorithm (1029 (79%) vs 1271 (45%)) because of fewer technical false positives. Pharmacist issued 437 PI targeting anticoagulant medicines, of which 266 PI (61%) were accepted by physicians. On the other hand, 1075 transmitted PI resulted in 505 accepted PI (47%). The difference was statistically significant (χ2=23.99; p<10–6). For both of the algorithms’ sets, transmission had the same importance: for the oral route, 29% vs 27%, respectively (NS). The acceptance rate was similar (81% and 75%, respectively (NS)).
Conclusion and relevance Algorithms about anticoagulant therapy medications were more efficient in the detection of DRP because of explicit clinical practice guidelines. The acceptance rate of PI by physicians was better. AVICENNE improved patient safety.
Conflict of interest No conflict of interest
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