Observational studyBMC medical informatics and decision making2019
Development and implementation of "Check of Medication Appropriateness" (CMA): advanced pharmacotherapy-related clinical rules to support medication surveillance.
Observational study in BMC medical informatics and decision making, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- A systematic review and meta-analysis on pharmacist-led interventions for the management of peptic ulcer disease.PloS one · 2025Pooled it
- Identifying potential prescribing safety indicators related to mental health disorders and medications: A systematic review.PloS one · 2019Pooled it
- Exploring hospital pharmacist perspectives on ethical considerations from automated patient prioritisation: a qualitative study.International journal of clinical pharmacy · 2026Article
- A Hybrid Rule-Based and Machine Learning-Based Clinical Decision Support System to Support Prescription Review: Development and External Validation Study.Journal of medical Internet research · 2026Article
- Article
- [Application and challenges of the clinical decision support system in hematological diseases].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2026Review
- Medication safety in patients with hepatic disease: proof of concept of a new approach to screen for patients at risk-a retrospective evaluation utilizing electronic prescribing systems.International journal of clinical pharmacy · 2025Article
- The impact of the bedside check of medication appropriateness (BED-CMA) at the hematology ward: a mixed-methods study.International journal of clinical pharmacy · 2025Article
- Evaluation and validation of a clinical decision support system for dose optimisation in hospitalized patients with (morbid) obesity - a retrospective, observational study.BMC medical informatics and decision making · 2025Observational
- Development and Implementation of a Clinical Decision Support System to Enhance Efficiency and Accuracy in Medication Prescription Review in a Tertiary Care Hospital: A Retrospective Hospital CDSS Register Study.Journal of multidisciplinary healthcare · 2025Article
- Evaluation and implementation of optimized antimicrobial dosing strategies in obese and underweight patients.Infection · 2024Article
- A Case-Study of Metoclopramide Prescription Error : A Grim Reminder.Journal of medical systems · 2024Article
- Development and implementation of medication-related clinical rules for obstetrics, gynaecology, and paediatric outpatients.European journal of hospital pharmacy : science and practice · 2024Article
- Development and retrospective evaluation of a clinical decision support system for the efficient detection of drug-related problems by clinical pharmacists.International journal of clinical pharmacy · 2023Article
- Detection of Drug-Related Problems through a Clinical Decision Support System Used by a Clinical Pharmacy Team.Healthcare (Basel, Switzerland) · 2023Article
- Electronic monitoring of potential adverse drug events related to lopinavir/ritonavir and hydroxychloroquine during the first wave of COVID-19.European journal of hospital pharmacy : science and practice · 2023Article
- Bedside check of medication appropriateness (BED-CMA) as a risk-based tool for bedside clinical pharmacy services: A proof-of-concept study at the trauma surgery ward.Computational and structural biotechnology journal · 2023Article
- Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review.Healthcare (Basel, Switzerland) · 2022Review
- End-users feedback and perceptions associated with the implementation of a clinical-rule based Check of Medication Appropriateness service.BMC medical informatics and decision making · 2022Article
- Development and assessment of PharmaCheck: an electronic screening tool for the prevention of twenty major adverse drug events.BMC medical informatics and decision making · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo improve medication surveillance and provide pharmacotherapeutic support in University Hospitals Leuven, a back-office clinical service, called "Check of Medication Appropriateness" (CMA), was developed, consisting of clinical rule based screening for medication inappropriateness. The aim of this study is twofold: 1) describing the development of CMA and 2) evaluating the preliminary results, more specifically the number of clinical rule alerts, number of actions on the alerts and acceptance rate by physicians.
methodsCMA focuses on patients at risk for potentially inappropriate medication and involves the daily checking by a pharmacist of high-risk prescriptions generated by advanced clinical rules integrating patient specific characteristics with details on medication. Pharmacists' actions are performed by adding an electronic note in the patients' medical record or by contacting the physician by phone. A retrospective observational study was performed to evaluate the primary outcomes during an 18-month study period.
results39,481 clinical rule alerts were checked by pharmacists for which 2568 (7%) electronic notes were sent and 637 (1.6%) phone calls were performed. 37,782 (96%) alerts were checked within four pharmacotherapeutic categories: drug use in renal insufficiency (25%), QTc interval prolonging drugs (11%), drugs with a restricted indication or dosing (14%) and overruled very severe drug-drug interactions (50%). The emergency department was a frequently involved ward and anticoagulants are the drug class for which actions are most frequently carried out. From the 458 actions performed for the four abovementioned categories, 69% were accepted by physicians.
conclusionsThese results demonstrate the added value of CMA to support medication surveillance in synergy with already integrated basic clinical decision support and bedside clinical pharmacy. Otherwise, the study also highlighted a number of limitations, allowing improvement of the service.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.