Clinical decision support for drug–drug interactions: Improvement needed

Abstract

Adverse drug events continue to have a negative impact on the delivery of health care in the United States.1 A common approach to solve this problem has been the addition of medication-related clinical-decision-support (CDS) software to pharmacy information systems. For decades, pharmacy information systems have utilized large databases of medication alerts, often supporting multiple alert types. One type of alert signals a drug–drug interaction (DDI). When reviewing patients’ medication profiles, pharmacists are often presented with interactions to review and integrate into drug therapy management decisions. However, a large number of clinically insignificant alerts are often displayed during the review process. The application of medication-related CDS software in practice often allows multiple members of the health care team to see these alerts. For example, an alert might be reviewed by a prescriber at the time of order entry, a pharmacist at the time of verification, and a nurse at the time of medication administration. Likewise, appropriate documentation of medication warnings in the electronic health record (EHR) provides timely and accurate communication to other members of the health care team. Alert acknowledgment and documentation are also vital to timely and appropriate patient care.