View source for Real-time pharmacy surveillance and clinical decision support to reduce adverse drug events in acute kidney injury – a randomized, controlled trial.

This is a review of McCoy, A.B., Cox, Z.L., Neal, E.B., Waitman, L.R., Peterson, N.B., Bhave, G., Siew, E.D., Danciu, I., Lewis, J.B. and Peterson, J.F. (2012). “Real-time pharmacy surveillance and clinical decision support to reduce adverse drug events in acute kidney injury – a randomized, controlled trial.” <ref> McCoy, A.B., Cox, Z.L., Neal, E.B., Waitman, L.R., Peterson, N.B., Bhave, G., Siew, E.D., Danciu, I., Lewis, J.B. and Peterson, J.F. (2012). Real-time pharmacy surveillance and clinical decision support to reduce adverse drug events in acute kidney injury – a randomized, controlled trial. Applied Clinical Informatics; 3: 221–238.  </ref>

= Background =
Medications comprise the largest source of medical errors in the healthcare industry today. Therefore building [[CDS]] systems to monitor the ordering and dispensing of prescription drugs could prevent significant morbidity, mortality and inefficiencies in hospitals around the world. Polypharmacy is not uncommon in today’s healthcare arena as people live longer with chronic disease often entailing much comorbidity. Numerous drugs are used to manage one individual’s health and drug-drug interactions can be all too common.

= Methods =
McCoy et al., (2012) examined whether adding pharmacy surveillance to a clinical practice already utilizing CDS [[alert]] software could reduce adverse drug events and/ or avoid occurrences of drug induced kidney dysfunction to patients with underlying renal disease. The authors carried out a randomized clinical trial with 396 patients who were admitted during a three month period. The intervention group received an extra look in by a pharmacist for medication events associated with declining renal function.

= Results =
McCoy and colleagues found no added benefit or reduction in kidney functioning between the control versus intervention groups. This study was fishing for a potential intervention which would potentially improve patient safety by reducing ADEs. When comparing provider response to abnormal serum creatinine due to active medications McCoy et al., (2012) found no “statistically significant differences between the control and intervention groups” (p.225).   

= Conclusion =
McCoy et al., (2012) found that “while CDS is effective at preventing (potential [[Adverse drug event]]s) pADEs and ADEs in patients with AKI, further research is necessary to determine whether surveillance can improve CDS performance” (p.227). 
This article was an enjoyable read; it is interesting how CDS is well accepted by many to improve clinical outcomes but yet proving it with statistics for many has remained quite elusive.

Related Read: [[Medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the pharmacy|Medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the pharmacy]]

= References =
<references/>
[[Category: Reviews]]
[[Category:CDS]]