{"id":605513,"date":"2024-01-21T02:30:01","date_gmt":"2024-01-20T23:30:01","guid":{"rendered":"https:\/\/en.buradabiliyorum.com\/study-shows-a-computerized-decision-support-system-reduces-high-risk-drug-combinations-in-icu-patients\/"},"modified":"2024-01-21T02:30:01","modified_gmt":"2024-01-20T23:30:01","slug":"study-shows-a-computerized-decision-support-system-reduces-high-risk-drug-combinations-in-icu-patients","status":"publish","type":"post","link":"https:\/\/buradabiliyorum.com\/en\/study-shows-a-computerized-decision-support-system-reduces-high-risk-drug-combinations-in-icu-patients\/","title":{"rendered":"#Study shows a computerized decision support system reduces high-risk drug combinations in ICU patients"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<label for=\"ez-toc-cssicon-toggle-item-6a394171e82eb\" class=\"ez-toc-cssicon-toggle-label\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #dd3333;color:#dd3333\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #dd3333;color:#dd3333\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/label><input type=\"checkbox\"  id=\"ez-toc-cssicon-toggle-item-6a394171e82eb\" checked aria-label=\"Toggle\" \/><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/buradabiliyorum.com\/en\/study-shows-a-computerized-decision-support-system-reduces-high-risk-drug-combinations-in-icu-patients\/#Fewer_but_more_impactful_alerts\" >Fewer, but more impactful alerts<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/buradabiliyorum.com\/en\/study-shows-a-computerized-decision-support-system-reduces-high-risk-drug-combinations-in-icu-patients\/#Shorter_stay_in_the_ICU\" >Shorter stay in the ICU<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/buradabiliyorum.com\/en\/study-shows-a-computerized-decision-support-system-reduces-high-risk-drug-combinations-in-icu-patients\/#Low-hanging_fruit\" >Low-hanging fruit<\/a><\/li><\/ul><\/nav><\/div>\n<div>\n<div class=\"article-gallery lightGallery\">\n<div data-thumb=\"https:\/\/scx1.b-cdn.net\/csz\/news\/tmb\/2024\/intensive-care-unit.jpg\" data-src=\"https:\/\/scx2.b-cdn.net\/gfx\/news\/hires\/2024\/intensive-care-unit.jpg\" data-sub-html=\"Credit: Pixabay\/CC0 Public Domain\">\n<figure class=\"article-img\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/scx1.b-cdn.net\/csz\/news\/800a\/2024\/intensive-care-unit.jpg\" alt=\"Intensive Care Unit\" title=\"Credit: Pixabay\/CC0 Public Domain\" width=\"800\" height=\"530\"\/><figcaption class=\"text-darken text-low-up text-truncate-js text-truncate mt-3\">\n                Credit: Pixabay\/CC0 Public Domain<br \/>\n            <\/figcaption><\/figure>\n<\/div>\n<\/div>\n<p>A multicenter study led by Amsterdam UMC and conducted in nine Dutch Intensive Care Units (ICUs) has shown that tailoring a computerized decision support system (CDSS) to the ICU environment significantly reduced the number of high-risk drug combinations administered to ICU patients. It also improved monitoring ICU patients when avoiding such combinations was not possible, and reduced the length of patients&#8217; stay in the ICU. This study is published in <i>The Lancet<\/i>.<\/p>\n<p>                                                                                                                                    &#8220;Not more, but fewer and more relevant alerts by a CDSS make such a system more valuable for health care providers and patients,&#8221; says Amsterdam UMC&#8217;s Professor of Medical Informatics Ameen Abu-Hanna, the study&#8217;s principal investigator.<\/p>\n<p>Combining two or more drugs at the same time can lead to either an increased effect or a reduced effect of the involved drugs. This may result in serious harm for patients. Drug combinations are more common in the ICU because ICU patients are seriously ill and, often, treated with many drugs at the same time.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Fewer_but_more_impactful_alerts\"><\/span>Fewer, but more impactful alerts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>CDSSs are used to alert ICU physicians about potentially risky drug combinations. These systems warn the physicians through alerts during drug prescribing. However, these systems are not properly tailored to the ICU environment, leading to an abundance of alerts that are not clinically relevant, which causes alert fatigue.<\/p>\n<p>Research shows that more than 80% of alerts for potentially risky drug combinations are dismissed by ICU physicians, including the important ones. This significantly diminishes the value of CDSS in daily clinical practice, and compromises patient safety.<\/p>\n<p>&#8220;Patients in the ICU are critically ill and are often treated with concomitant drugs. At the same time, ICU patients are extensively and continuously monitored. Therefore, it is important to tailor the CDSS to the ICU environment to prevent alert fatigue and improve patient safety in the ICU,&#8221; says Assistant Professor and co-author, Joanna Klopotowska.<\/p>\n<p>                                                                                                        <!-- Google middle Adsense block --><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Shorter_stay_in_the_ICU\"><\/span>Shorter stay in the ICU<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Contrary to the current indiscriminate CDSSs, nine ICUs received during some period a CDSS that was carefully tailored to the ICU environment. This tailored system only showed alerts for drug combinations that were considered high-risk or needing extra monitoring, as defined by a national panel of ICU physicians and hospital pharmacists.<\/p>\n<p>The alerts for low-risk drug combinations were turned off. As a result of this adjustment, 12% fewer high-risk drug combinations were administered in the ICU patients, and the monitoring of possible side-effects pertaining to high-risk drug combinations was improved. Patients&#8217; stay in the ICU was also shortened.<\/p>\n<p>This study shows that tailoring a CDSS to the ICU environment improves patient safety in the ICU patients. By alerting only where it matters, the ICU physicians were able to better recognize the dangerous drug combinations. This <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/download-scripts-themes-apps\/\" data-internallinksmanager029f6b8e52c=\"9\" title=\"Download Scripts &amp; Themes &amp; Apps\" target=\"_blank\" rel=\"noopener\">app<\/a>roach can also be valuable for other groups of patients such as neonatology, pediatrics and oncology.<\/p>\n<p>At the moment, many hospitals use CDSSs without customization to their specific patient groups, and the systems&#8217; effectiveness is seldom scrutinized.<\/p>\n<p>&#8220;We hope that our study inspires and stimulates hospitals to take a more critical look at all the alerts that health care providers receive through such systems. This will benefit patients and health care providers,&#8221; says Klopotowska.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Low-hanging_fruit\"><\/span>Low-hanging fruit<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Even the ICU departments that did not participate in the study can easily adapt their CDSS today and make it more effective. These adjustments can be made manually in the existing systems and require minimal effort. To this end, the researchers have published two lists.<\/p>\n<p>A list of drug combinations that are high-risk in the ICU, for which alerts should be enabled, and a list of low-risk drug combinations that do not require alerts.<\/p>\n<p>&#8220;Adapting ICU CDSSs is a low-hanging fruit that all ICUs in the Netherlands and beyond can benefit from, they do not have to reinvent the wheel for themselves,&#8221; adds Tinka Bakker, at the time of the study the Ph.D. candidate and co-author of the study. On 7 December 2023, she defended her thesis at the University of Amsterdam about tailoring the CDSS to the ICU environment.<\/p>\n<div class=\"article-main__more p-4\">\n                                                                                                    <strong>More information:<\/strong><br \/>\n                                                    The effect of intensive care tailored computerised decision support alerts on administration of high-risk drug combinations, and their monitoring. A cluster randomised stepped-wedge trial, <i>The Lancet<\/i> (2024).<\/p><\/div>\n<p>                                                Provided by<br \/>\n                                                                                                    Amsterdam University Medical Center<\/p>\n<p>                                        <!-- print only --><\/p>\n<div class=\"d-none d-print-block\">\n<p>                                                 <strong>Citation<\/strong>:<br \/>\n                                                 Study shows a computerized decision support system reduces high-risk drug combinations in ICU patients (2024, January 20)<br \/>\n                                                 retrieved 21 January 2024<br \/>\n                                                 from https:\/\/medicalxpress.com\/<a href=\"https:\/\/buradabiliyorum.com\/en\/category\/news\/\" data-internallinksmanager029f6b8e52c=\"2\" title=\"News\" target=\"_blank\" rel=\"noopener\">news<\/a>\/2024-01-computerized-decision-high-drug-combinations.html<\/p>\n<p>                                            This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no<br \/>\n                                            part may be reproduced without the written permission. The content is provided for information purposes only.<\/p><\/div>\n<\/p><\/div>\n<p><script id=\"facebook-jssdk\" async=\"\" src=\"https:\/\/connect.facebook.net\/en_US\/sdk.js\"><\/script><\/p>\n<blockquote><p><strong><span style=\"color: #ff6600;\">If you liked the article, do not forget to share it with your friends. 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It also improved monitoring ICU patients when avoiding such&#8230;<\/p>\n","protected":false},"author":1,"featured_media":605514,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"fifu_image_url":"https:\/\/scx2.b-cdn.net\/gfx\/news\/hires\/2024\/intensive-care-unit.jpg","fifu_image_alt":"","footnotes":""},"categories":[16],"tags":[],"class_list":["post-605513","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sciencee"],"_links":{"self":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts\/605513","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/comments?post=605513"}],"version-history":[{"count":0,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts\/605513\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/media\/605514"}],"wp:attachment":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/media?parent=605513"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/categories?post=605513"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/tags?post=605513"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}