ArticleBMC geriatrics2019
Clinical relevance of alerts from a decision support system, PHARAO, for drug safety assessment in the older adults.
Article in BMC geriatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Drug-Induced QT Prolongation: Associations Between Risk Classifications in a Swedish Clinical Decision Support System and Clinical Outcomes.Clinical pharmacology and therapeutics · 2026Article
- Potential Adverse Drug Events Identified with Decision Support Algorithms from Janusmed Risk Profile-A Retrospective Population-Based Study in a Swedish Region.Pharmacy (Basel, Switzerland) · 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
- Potential Drug Interactions in Adults Living in Manaus: A Real-World Comparison of Two Databases, 2019.Turkish journal of pharmaceutical sciences · 2022Article
- Clinical validation of clinical decision support systems for medication review: A scoping review.British journal of clinical pharmacology · 2022Article
- The Influence of Pharmacogenetics on the Clinical Relevance of Pharmacokinetic Drug-Drug Interactions: Drug-Gene, Drug-Gene-Gene and Drug-Drug-Gene Interactions.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Current Knowledge about Providing Drug-Drug Interaction Services for Patients-A Scoping Review.Pharmacy (Basel, Switzerland) · 2021Article
- Prevalence and sort of pharmacokinetic drug-drug interactions in hospitalized psychiatric patients.Journal of neural transmission (Vienna, Austria : 1996) · 2020Article
- Kidney function and nephrotoxic drug use among older home-dwelling persons with or without diabetes in Finland.BMC nephrology · 2020Article
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPHARAO is a decision support system developed to evaluate the risk for a set of either common or serious side-effects resulting from a combination of pharmacodynamic effects from a patient's medications. The objective of this study was to investigate the validity of the risk scores for the common side-effects generated by PHARAO in older patients.
methodsSide-effects included were sedation, constipation, orthostatic symptoms, anticholinergic and serotonergic effects. The alerts generated by PHARAO were tested in 745 persons ≥65 years old. Dispensed prescriptions retrieved from the Swedish prescribed drug register were used to generate the pharmacological risk scores of patients' medications. Symptoms possibly related to side-effects were extracted from medical records data.
resultsThe PHARAO system generated 776 alerts, most often for the risk of anticholinergic symptoms. The total specificity estimates of the PHARAO system were 0.95, 0.89 and 0.78 for high, intermediate and low risk alerts, respectively. The corresponding sensitivity estimates were between 0.12 and 0.37. The negative predictive value was 0.90 and the positive predictive value ranged between 0.20-0.25.
conclusionsThe PHARAO system had a high specificity and negative predictive value to detect symptoms possibly associated with the of patients' medications, while the sensitivity and positive predictive value were low. The PHARAO system has the potential to minimise the risk of over-alerts in combination with a drug-drug interaction alert system, but should be used in connection with a medical evaluation of the patient.
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