Drug interactions with dementia-related pathophysiological pathways worsen or prevent dementia.
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ABSTRACT:
SUBMITTER: Barus R
PROVIDER: S-EPMC6715604 | biostudies-literature | 2019 Sep
REPOSITORIES: biostudies-literature
Publications
Drug interactions with dementia-related pathophysiological pathways worsen or prevent dementia.
Barus Romain R Béné Johana J Deguil Julie J Gautier Sophie S Bordet Régis R
British journal of pharmacology 20190331 18
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Project description:BackgroundPharmacists often overlook drug interaction alerts because of limitations in clinical decision support (CDS) software systems intended to detect evidence-based, clinically significant drug-drug interactions (DDIs). Alert fatigue, which occurs when pharmacists become desensitized to an overload of DDIs, may also contribute.ObjectivesTo gain a better understanding of how pharmacists assess common DDIs and the extent to which computerized drug alerts affect their decision-making, as background for initiatives to overcome alert fatigue and improve detection of DDIs.MethodsThis qualitative study used focus group methodology. A structured focus group was planned at each of 3 large tertiary hospitals. Pharmacists were invited to participate if their jobs included patient care and/or dispensary responsibilities. The focus group discussions were audio-recorded and subsequently transcribed, analyzed, and coded into themes using NVivo software. Four main categories of themes were identified: perceived challenges, pharmacists' assessment of DDIs, barriers to responding to alerts, and proposed solutions.ResultsThe participants (n = 24) described a large discrepancy among CDS software systems in terms of the severity of specific DDIs, which made it difficult to view these systems as reliable sources. The participants agreed that alert fatigue is present and contributes to DDIs being overlooked. However, lack of patient information to make an initial assessment, as well as the constant need for multitasking, prevents pharmacists from focusing on the evaluation of DDIs.ConclusionsAlthough alert fatigue was reported to be a common factor responsible for pharmacists missing DDIs, other barriers also exist. Participants suggested ways to limit DDI alerts to those that are clinically relevant. Having a collaborative team of pharmacists periodically review the DDIs embedded in the CDS system, incorporating a colour-code system, and removing duplicate entries were discussed as ways to improve system efficiency.
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