PT - JOURNAL ARTICLE AU - Paloma Arias Pou AU - Irene Aquerreta Gonzalez AU - Antonio Idoate GarcĂ­a AU - Nuria Garcia-Fernandez TI - Improvement of drug prescribing in acute kidney injury with a nephrotoxic drug alert system AID - 10.1136/ejhpharm-2017-001300 DP - 2019 Jan 01 TA - European Journal of Hospital Pharmacy PG - 33--38 VI - 26 IP - 1 4099 - http://ejhp.bmj.com/content/26/1/33.short 4100 - http://ejhp.bmj.com/content/26/1/33.full SO - Eur J Hosp Pharm2019 Jan 01; 26 AB - Objective Electronic alert systems have shown their capacity for improving the detection of acute kidney injury (AKI). The aim of this study was to design and implement a clinical decision support system (CDSS) for improving drug selection and reducing nephrotoxic drug use in patients with AKI.Methods The study was designed as an intervention study comparing a pre and post cohort of patients admitted during April 2014 and April 2015, respectively (phase I and phase II). The intervention was a CDSS which provided kidney function and nephrotoxic drug information. Furthermore, an interruptive alert was designed to detect patients suffering an AKI event while taking a nephrotoxic drug and to see if the dose was then reduced or the drug was discontinued by the physicians.Results One-third of the inpatients were included in the analysis because they met the inclusion criteria (1004 and 1002 patients in phases I and II, respectively). 735 and 761 of them received at least one nephrotoxic alert (73% vs 76%; p=0.763). 65 and 88 patients suffered AKI during admission (6.5% vs 8.8%; p=0.051). In phase I, patients received 384 nephrotoxic alerts (55%) with 78 (20%) of them provoking a change or discontinuation of the nephrotoxic drug. In phase II this value increased to 154 out of 526 (29%) after implementation of the CDSS (p<0.01).Conclusions A CDSS with interruptive alerts that inform of the development of AKI in real time in patients with nephrotoxic drug prescription has a positive impact on the judicious use of these drugs.