Implementation of a clinical decision support system for the optimization of antidiabetic drug orders by pharmacists
L. Robert, P. Quindroit, H. Henry, M. Perez, C. Rousselière, M. Lemaitre, A. Vambergue, B. Décaudin, J.‐B. Beuscart- Pharmacology (medical)
- Pharmacology
Aim
The objective of the study was to describe the impact of a clinical decision support system (CDSS) on antidiabetic drug management by clinical pharmacists for hospitalized patients with T2DM.
Methods
We performed a retrospective, single‐center study in a teaching hospital, where clinical pharmacists analyzed prescriptions and issued pharmacist interventions (PIs) through a computerized physician order entry (CPOE) system. A CDSS was integrated into the pharmacists’ workflow in July 2019. We analyzed PIs during two periods of interest: one before the introduction of the CDSS (from November 2018 to April 2019, PIs issued through the CPOE alone) and one afterwards (from November 2020 to April 2021, PIs issued through the CPOE and/or the CDSS). The study covered non‐diabetology wards as endocrinology, diabetes and metabolism departments were not computerized at the time of the study.
Results
There were 203 PIs related to antidiabetic drugs in period 1 and 319 in period 2 (a 57.5% increase). Sixty‐four of the 319 PIs were generated by the CDSS. Noncompliance/contraindication was the main problem identified by the CDSS (41 PIs, 68.4%), and 57.8% led to discontinuation of the drug. Most of the PIs issued through the CDSS corresponded to orders that had not been flagged up by clinical pharmacists using the CPOE. Conversely, most alerts about indications that were not being treated were detected by the clinical pharmacists using the CPOE and not by the CDSS.
Conclusion
Use of CDSS by clinical pharmacists improved antidiabetic drug management for hospitalized patients with T2DM. The CDSS might add value to diabetes care in non‐diabetology wards by decreasing the frequency of potentially inappropriate prescriptions and adverse drug reactions.