Effect of developing a computerized drug-drug interaction monitoring program at Mahasarakham Hospital

Abstract

Objective : To evaluate the effectiveness of a program developed to prevent adverse events from drug interactions.

Methods : This retrospective study involved gathering data through data collection methods and processing prescription information from the hospital database. The study was divided into two phases: the preprogram development phase, spanning from October 1, 2017, to September 30, 2020, and the postprogram development phase, covering October 1, 2020, to September 30, 2023. Data analysis was conducted using descriptive statistics, including frequency, percentage, and fisher's exact test analysis.

Results : Program and database adjustments resulted in a significant increase in the detection of drug - drug interactions by more than 2-fold. Prior to the adjustments, adverse events from drug interactions with severity level E, such as instances of bleeding, occurred twice, necessitating intervention for adverse reactions. Additionally, patients with elevated INR levels were observed 13 times. After the program and database adjustments, no patients with bleeding events were identified, but there was an increase in patients with elevated INR levels, specifically 17 patients with bleeding events. Regarding errors in drug prescribing and dispensing, statistically significant reductions were observed (p=0.033 and p=0.028, respectively). Before the adjustments, severe errors in drug prescribing at levels B and above occurred 248 times and 80 times, respectively. After the adjustments, the number of prescribing errors decreased significantly, with 142 times at level B and only 4 times at level C and above.

Conclusion : The development of a computer program and database aimed at preventing drug interactions has enhanced the ability to detect and alert healthcare professionals to potential drug interactions. This approach can assists physicians and pharmacists in minimizing medication errors and preventing adverse drug events. The system has been effective in reducing prescribing and administration errors, contributing to a safer and more efficient patient care environment. To further improve treatment efficiency and patient safety, it is advisable to implement computerized medication ordering systems throughout the hospital.