Effectiveness of an Advanced Clinical Decision Support System on Clinical Decision-Making Skills in a Call Center Medication Therapy Management Pharmacy Setting: A Pilot Study.

Jennifer M Bingham,Jacques Turgeon,David R Axon,Veronique Michaud

doi:10.3390/pharmacy8040228

Abstract

(1) Background: There is limited evidence related to the efficacy of advanced clinical decision support systems (CDSS) on the quantity of high-quality clinical recommendations in a pharmacy-related medication therapy management (MTM) setting. The study aimed to assess the effect of an advanced CDSS on the quantity of relevant clinical pharmacist recommendations in a call center MTM setting. (2) Methods: This pre-test/post-test with comparator group study compared clinical skills assessment scores between certified MTM pharmacists in March 2020. A Wilcoxon Signed Rank test assessed the difference between pre- and post-test scores in both groups. (3) Results: Of 20 participants, the majority were less than 40 years old (85%) with a Doctor of Pharmacy degree (90%). Nine were female. Intervention group participants had less than three years of experience as a pharmacist. The control group had less than three years (40%) or seven to ten years (40%) of experience. There was a significant increase in intervention group scores between pre- (median = 3.0, IQR = 3.0) and post-test segments (median = 6.5, IQR = 4.0, p = 0.02). There was no significant change between control group pre- and post-test segments (p = 0.48). (4) Conclusion: Pharmacist exposure to an advanced CDSS was associated with significantly increased quantity of relevant clinical recommendations in an MTM pharmacy setting.

Highlights

Polypharmacy is associated with a higher risk of drug-drug interactions and adverse drug events (ADEs) [1]
(4) Conclusion: Pharmacist exposure to an advanced Clinical decision support systems (CDSS) was associated with significantly increased quantity of relevant clinical recommendations in an medication therapy management (MTM) pharmacy setting
One medication therapy management pharmacist call center location served as the intervention site (Florida) and the other served as the control site (Arizona)

Summary

Introduction

Polypharmacy is associated with a higher risk of drug-drug interactions and adverse drug events (ADEs) [1]. Pharmacists play a key role in the prevention and detection of drug-drug interactions (DDI) [2]. It is critical for pharmacists to intervene and improve the medication safety profile of drug regimens for patients with multiple chronic diseases and polypharmacy; yet, few clinical tools are available to accurately assess these complex regimens for interactions and ADEs [3]. Interpretation by healthcare providers can be difficult when there is polypharmacy [6]. Despite an abundance of information, healthcare providers cannot always rely on the clinical relevance of these commercially available CDSS because they do not consider medication timing, medication dose, and patient comorbidities [6]

Results

Discussion

Conclusion