Evidence map›Paper›PMID 34023885›Full record

ArticleAmerican journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists2021

Impact of clinical decision support therapeutic interchanges on hospital discharge medication omissions and duplications.

Erin Maxwell, James Amerine, Glenda Carlton, Jennifer L Cruz, Ashley L Pappas, Gregory A Heindel

Open access · greenAbstract read
In one paragraph

Article in American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 55% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Erin MaxwellPharmacy Services, UNC Health System, Morrisville, NC, USA.
James AmerineDepartment of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC, USA.
Glenda CarltonEshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.
Jennifer L CruzDepartment of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC, USA.
Ashley L PappasPharmacy Services, UNC Health System, Morrisville, NC, USA.
Gregory A HeindelPharmacy Services, UNC Health System, Morrisville, NC, USA.
University of North Carolina at Chapel Hill · USUniversity of North Carolina System · US

Funding

Re-Entry Supplement: Investigation of Oral Microbial Enzymes for the Detection and Treatment of Periodontal DiseaseUL1TR002489 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, SHAHEEN, NICHOLAS J · 2018 to 2022
$48.6M
NCATS NIH HHSNCATS NIH HHS UL1 TR002489NIH HHS UL1TR002489
6 · The paper itself

Abstract

purposeAutomatic therapeutic substitution (ATS) protocols are formulary tools that allow for provider-selected interchange from a nonformulary preadmission medication to a formulary equivalent. Previous studies have demonstrated that the application of clinical decision support (CDS) tools to ATS can decrease ATS errors at admission, but there are limited data describing the impact of CDS on discharge errors. The objective of this study was to describe the impact of CDS-supported interchanges on discharge prescription duplications or omissions.

methodsThis was a single-center, retrospective cohort study conducted at an academic medical center. Patients admitted between June 2017 and August 2019 were included if they were 18 years or older at admission, underwent an ATS protocol-approved interchange for 1 of the 9 included medication classes, and had a completed discharge medication reconciliation. The primary outcome was difference in incidence of therapeutic duplication or omission at discharge between the periods before and after CDS implementation.

resultsA total of 737 preimplementation encounters and 733 postimplementation encounters were included. CDS did not significantly decrease the incidence of discharge duplications or omissions (12.1% vs 11.2%; 95% confidence interval [CI], -2.3% to 4.2%) nor the incidence of admission duplication or inappropriate reconciliation (21.4% vs 20.7%; 95% CI, -3.4% to 4.8%) when comparing the pre- and postimplementation periods. Inappropriate reconciliation was the primary cause of discharge medication errors for both groups.

conclusionCDS implementation was not associated with a decrease in discharge omissions, duplications, or inappropriate reconciliation. Findings highlight the need for thoughtful medication reconciliation at the point of discharge.

Indexed as

Decision Support Systems, ClinicalPatient DischargeHospitalsHumansMedication ReconciliationRetrospective Studiesformulary stewardshipmedication reconciliationmedication-use policypharmacy technologytherapeutic interchange

Identifiers

PMID34023885
PMCPMC8194524
OpenAlexW3164167325

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.