Pharmacy Department, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium.
Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
J Med Syst. 2024 Sep 30;48(1):93. doi: 10.1007/s10916-024-02113-8.
Fixed and broad screening intervals for drug-drug interaction (DDI) alerts lead to false positive alerts, thereby contributing to alert fatigue among healthcare professionals. Hence, we aimed to investigate the impact of customized screening intervals on the daily incidence of DDI alerts. An interrupted time series analysis was performed at the University Hospitals Leuven to evaluate the impact of a pragmatic intervention on the daily incidence of DDI alerts per 100 prescriptions. The study period encompassed 100 randomly selected days between April 2021 and December 2022. Preceding the intervention, a fixed and broad screening interval of 7 days before and after prescribing an interacting drug was applied. The intervention involved implementing customized screening intervals for a subset of highly prevalent or clinically relevant DDIs into the hospital information system. Additionally, the sensitivity of the tailored approach was evaluated. During the study period, a mean of 5731 (± 2909) new prescriptions per day was generated. The daily incidence of DDI alerts significantly decreased from 9.8% (95% confidence interval (CI) 8.4;11.1) before the intervention, to 6.3% (95% CI 5.4;7.2) afterwards, p < 0.0001. This corresponded to avoiding 201 (0.035*5731) false positive DDI alerts per day. Sensitivity was not compromised by our intervention. Defining and implementing customized screening intervals was feasible and effective in reducing the DDI alert burden without compromising sensitivity.
固定且宽泛的药物相互作用（DDI）警报筛查间隔会导致假阳性警报，从而导致医疗保健专业人员的警报疲劳。因此，我们旨在研究定制筛查间隔对 DDI 警报每日发生率的影响。在鲁汶大学医院进行了一项中断时间序列分析，以评估一项实用干预措施对每 100 份处方 DDI 警报每日发生率的影响。研究期间包括 2021 年 4 月至 2022 年 12 月之间随机选择的 100 天。在干预之前，应用了一种固定且宽泛的筛查间隔，即在开具有相互作用的药物之前和之后的 7 天内进行筛查。干预措施包括将高度常见或临床相关 DDI 的定制筛查间隔纳入医院信息系统。此外，还评估了定制方法的敏感性。在研究期间，平均每天生成 5731 份（±2909 份）新处方。DDI 警报的每日发生率从干预前的 9.8%（95%置信区间 8.4%；11.1%）显著下降至干预后的 6.3%（95%置信区间 5.4%；7.2%），p<0.0001。这相当于每天避免 201 次（0.035*5731）假阳性 DDI 警报。我们的干预措施并没有降低敏感性。定义和实施定制筛查间隔是可行且有效的，可以在不影响敏感性的情况下减轻 DDI 警报负担。
