PMID- 35523537
OWN - NLM
STAT- MEDLINE
DCOM- 20240226
LR  - 20240228
IS  - 2047-9956 (Print)
IS  - 2047-9964 (Electronic)
IS  - 2047-9956 (Linking)
VI  - 31
IP  - 2
DP  - 2024 Feb 22
TI  - Development and implementation of medication-related clinical rules for 
      obstetrics, gynaecology, and paediatric outpatients.
PG  - 101-106
LID - 10.1136/ejhpharm-2021-003170 [doi]
AB  - OBJECTIVES: Prescription errors can cause serious adverse drug events. Clinical 
      decision support systems prevent prescription errors; however, real-time clinical 
      rules in obstetrics, gynaecology, and paediatric outpatients remain unexplored. 
      We evaluated the effects of localised, real-time clinical rules on alert rates 
      and acceptance rates compared with manual prescription review. METHODS: We 
      developed real-time clinical rules that incorporate information systems to obtain 
      characteristic information and laboratory values. We conducted a retrospective 
      cohort study to compare the alert and recommendation acceptance rates of all 
      prescription error types before and after clinical rule implementation in 
      obstetrics, gynaecology, and paediatrics. Clinical rules, prescription error 
      types, and alerts were determined by a prescribing review committee comprising 
      physicians, pharmacists, nurses, and administrators. The difference in alert and 
      acceptance rates between the groups was analysed using relative risk. RESULTS: 
      The number of alerts increased after clinical rules implementation; the number of 
      on-duty pharmacists for review decreased from 10 to 2. Compared with those with 
      manual review, the alert rates for paediatrics and obstetrics and gynaecology 
      increased with the clinical rules by 3.97- and 11.26-fold, respectively, and the 
      alert rates for drug-drug interactions (DDIs) and combined medication errors in 
      obstetrics and gynaecology increased with the clinical rules by 26.10- and 
      26.54-fold, respectively. In paediatrics, the alert rate for all prescription 
      error types was higher with the clinical rules review than with the manual 
      review; the alert rates for DDI, dosage, and combination medication errors were 
      significantly different between the clinical rules and the manual review. 
      However, there was no difference in the recommendation acceptance rate between 
      the manual review and the clinical rules. CONCLUSIONS: Clinical rules can 
      identify prescription errors that manual review cannot detect and ensure 
      real-time review efficiency in high-volume outpatient prescription settings. The 
      high acceptance rate and modification of prescriptions may be relevant to highly 
      customised and localised clinical rules.
CI  - (c) European Association of Hospital Pharmacists 2024. Re-use permitted under CC 
      BY-NC. No commercial re-use. Published by BMJ.
FAU - Chen, Quanyao
AU  - Chen Q
AUID- ORCID: 0000-0003-4408-2565
AD  - Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen 
      University, Xiamen, Fujian, China.
FAU - Wang, Luwei
AU  - Wang L
AD  - Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen 
      University, Xiamen, Fujian, China.
FAU - Lin, Min
AU  - Lin M
AD  - Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen 
      University, Xiamen, Fujian, China.
FAU - Chen, Weida
AU  - Chen W
AD  - Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen 
      University, Xiamen, Fujian, China.
FAU - Wu, Wen
AU  - Wu W
AD  - Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen 
      University, Xiamen, Fujian, China.
FAU - Chen, Yao
AU  - Chen Y
AD  - Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen 
      University, Xiamen, Fujian, China chenyaoxm@126.com.
LA  - eng
PT  - Journal Article
DEP - 20240222
PL  - England
TA  - Eur J Hosp Pharm
JT  - European journal of hospital pharmacy : science and practice
JID - 101578294
SB  - IM
MH  - Humans
MH  - Child
MH  - Outpatients
MH  - *Gynecology
MH  - Retrospective Studies
MH  - *Drug-Related Side Effects and Adverse Reactions
MH  - Medication Errors/prevention & control
PMC - PMC10895191
OTO - NOTNLM
OT  - Automation
OT  - Drug Administration Routes
OT  - MEDICAL ERRORS
OT  - MEDICATION SYSTEMS, HOSPITAL
OT  - PHARMACY SERVICE, HOSPITAL
OT  - Quality Assurance, Health Care
OT  - Quality of Health Care
OT  - Safety
COIS- Competing interests: None declared.
EDAT- 2022/05/07 06:00
MHDA- 2024/02/26 06:43
PMCR- 2022/05/06
CRDT- 2022/05/06 21:12
PHST- 2021/11/25 00:00 [received]
PHST- 2022/04/12 00:00 [accepted]
PHST- 2024/02/26 06:43 [medline]
PHST- 2022/05/07 06:00 [pubmed]
PHST- 2022/05/06 21:12 [entrez]
PHST- 2022/05/06 00:00 [pmc-release]
AID - ejhpharm-2021-003170 [pii]
AID - 10.1136/ejhpharm-2021-003170 [doi]
PST - epublish
SO  - Eur J Hosp Pharm. 2024 Feb 22;31(2):101-106. doi: 10.1136/ejhpharm-2021-003170.