ArticleApplied clinical informatics2019
Development and Evaluation of a Clinical Decision Support System to Improve Medication Safety.
Article in Applied clinical informatics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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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
23 citing papers in PubMed, 37 citations in OpenAlex.
- Trial
- 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
- Supratherapeutic drug concentration triggers: A novel data-driven approach to assess their value for medication safety surveillance in intensive care.British journal of clinical pharmacology · 2026Article
- Patient Participation in Monitoring Potential Adverse Drug Events.Applied clinical informatics · 2025Observational
- 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
- Review
- Optimization and impact of an evidence-based pre-audit prescription decision system in primary healthcare settings.Frontiers in pharmacology · 2025Article
- We Ask and Listen: A Group-Wide Retrospective Survey on Satisfaction with Digital Medication Software.Journal of multidisciplinary healthcare · 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
- Article
- 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
- The Effect of Digitization on the Safe Management of Anticoagulants.Applied clinical informatics · 2022Article
- 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
- Clinical validation of clinical decision support systems for medication review: A scoping review.British journal of clinical pharmacology · 2022Article
- Evaluation of Clinical Decision Support to Reduce Sedative-Hypnotic Prescribing in Older Adults.Applied clinical informatics · 2021Article
- Optimizing Clinical Monitoring Tools to Enhance Patient Review by Pharmacists.Applied clinical informatics · 2021Article
- Drug Alert Experience and Salience during Medical Residency at Two Healthcare Institutions.Applied clinical informatics · 2021Article
- A Narrative Review of Clinical Decision Support for Inpatient Clinical Pharmacists.Applied clinical informatics · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical decision support systems (CDSSs) are a good strategy for preventing medication errors and reducing the incidence and severity of adverse drug events (ADEs). However, these systems are not very effective and are subject to multiple limitations that prevent their implementation in clinical practice.
objectivesThe objective of this study was to evaluate the effectiveness of an advanced CDSS, HIGEA, which generates alerts based on predefined clinical rules to identify patients at risk of an ADE.
methodsA multidisciplinary team defined the system and the clinical rules focusing on medication errors commonly encountered in clinical practice. Four intervention programs were defined: (1) dose adjustment in renal impairment; (2) adjustment of anticoagulation/antiplatelet therapy; (3) detection of biochemical/hematologic toxicities; and (4) therapeutic drug monitoring. We performed a 6-month observational prospective study to analyze the effectiveness of these clinical rules by calculating the positive predictive value (PPV).
resultsThe team defined 211 clinical rules. During the study period, HIGEA generated 1,086 alerts (8.9 alerts per working day), which were reviewed by pharmacists. Fifty-one percent (554/1,086) of alerts generated an intervention to prevent a possible ADE; of these, 66% (368/554) required a documented modification to therapy owing to a real prescription error intercepted. The intervention program that induced the highest number of modifications to therapy was the dose adjustment in renal impairment program (PPV = 0.51), followed by the adjustment of anticoagulation/antiplatelet therapy program (PPV = 0.24). The percentage of accepted interventions was similar in surgical units (68%), medical units (67%), and critical care units (63%).
conclusionOur study offers evidence that HIGEA is highly effective in preventing potential ADEs at the prescription stage.
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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.