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首页> 外文期刊>Pharmacoepidemiology and drug safety >Evaluation of drug interactions and dosing in 484 neurological inpatients using clinical decision support software and an extended operational interaction classification system (Zurich Interaction System).
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Evaluation of drug interactions and dosing in 484 neurological inpatients using clinical decision support software and an extended operational interaction classification system (Zurich Interaction System).

机译：使用临床决策支持软件和扩展的操作交互分类系统（Zurich Interaction System），对484名神经科住院患者进行药物交互作用和用药评估。

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PURPOSE: The current study aimed at identifying and quantifying critical drug interactions in neurological inpatients using clinical decision support software (CDSS). Reclassification of interactions with a focus on clinical management aimed to support the development of CDSS with higher efficacy to reduce overalerting and improve medication safety in clinical practice. METHODS: We conducted a cross-sectional study in consecutive patients admitted to the neurology ward of a tertiary care hospital. We developed a customized interface for mass analysis with the CDSS MediQ, which we used for automated retrospective identification of drug interactions during the first day of hospitalization. Interactions were reclassified according to the Zurich Interaction System (ZHIAS), which incorporates the Operational Classification of Drug Interactions (ORCA). Dose adjustments for renal impairment were also evaluated. RESULTS: In 484 patients with 2812 prescriptions, MediQ generated 8 "high danger," 518 average danger, alerts involved contraindicated and 33 alerts involved provisionally contraindicated combinations, and 327 alerts involved a conditional and 1393 alerts involved a minimal risk of adverse outcomes. Thirty-five patients (6.2%) had at least one combination that was at least provisionally contraindicated. ZHIAS also provides categorical information on expected adverse outcomes and management recommendations, which are presented in detail. We identified 13 prescriptions without recommended dose adjustment for impaired renal function. CONCLUSIONS: MediQ detected a large number of drug interactions with variable clinical relevance in neurological inpatients. ZHIAS supports the selection of those interactions that require active management, and the effects of its implementation into CDSS on medication safety should be evaluated in future prospective studies. Copyright (c) 2011 John Wiley & Sons, Ltd.
机译：目的：本研究旨在使用临床决策支持软件（CDSS）识别和量化神经科住院患者中的关键药物相互作用。以临床管理为重点的相互作用重分类，旨在支持具有更高功效的CDSS的开发，以减少过度警惕并提高临床实践中的药物安全性。方法：我们对三级医院神经科病房的连续患者进行了横断面研究。我们使用CDSS MediQ开发了用于质量分析的自定义界面，该界面用于住院第一天的药物相互作用的自动回顾性鉴定。根据苏黎世互动系统（ZHIAS）对互动进行了重新分类，该系统包含了药物互动的操作分类（ORCA）。还评估了肾功能不全的剂量调整。结果：在484例患者中，有2812个处方，MediQ产生8个“高危”，518个平均危险，禁忌警报和33个临时禁忌警报，以及有条件的327次警报和1393次的不良后果风险最小。三十五名患者（6.2％）至少有一种至少暂时禁忌的组合。 ZHIAS还提供有关预期不良后果的分类信息和管理建议，并进行了详细介绍。我们确定了13项未建议调整肾功能受损的处方。结论：MediQ在神经科住院患者中检测到大量药物相互作用，具有不同的临床相关性。 ZHIAS支持选择需要积极管理的相互作用，并且应在未来的前瞻性研究中评估将其实施到CDSS中对药物安全性的影响。版权所有（c）2011 John Wiley＆Sons，Ltd.

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