Impact of a clinical decision support system for drug dosage in patients with renal failure.

摘要: Background A clinical decision support system (CDSS) linked to the computerized physician order entry may help improve prescription appropriateness in inpatients with renal insufficiency. Objective To evaluate impact on of a CDSS prescriber alert for 85 drugs failure patients. Setting Before-after study 975-bed academic hospital. Method Prescriptions patients were reviewed during two comparable periods 6 days each, before and after implementation (September 2009 2010). Main outcome measure The proportion inappropriate dosages included was compared pre- post-implementation group. Results Six hundred fifteen (301 314 periods). In period, respectively 2882 3485 prescriptions evaluated, which 14.9 16.6% triggered an alert. Among these, dosage 25.4 24.6% (OR 0.97; 95% CI 0.72–1.29). most frequently involved paracetamol, perindopril, tramadol allopurinol. Conclusion did not significantly reduce drug failure. Further research is required investigate reasons why prescribers override alerts. Collaboration pharmacists might compliance recommendations.