A recent cluster randomized stepped-wedge trial conducted by Joanna Klopotowska, PhD, PharmD, at Amsterdam University Medical Center, demonstrated a 12% decrease in high-risk drug combinations in ICUs by tailoring potential drug-drug interaction (DDI) alerts. The study involved nearly 10,000 ICU patients, revealing a mean reduction from 35.6 to 26.2 administered high-risk drug combinations per 1,000 drug administrations per patient. Additionally, the intervention group experienced a shorter ICU stay and a 9% higher proportion of appropriately monitored high-risk drug combinations. The tailored Medication Interaction Module CDSS, named MiM+, was implemented, focusing on clinically relevant DDIs in the ICU setting. The study emphasizes the challenges of real-world application of clinical decision support systems in the ICU and highlights the need for smarter, user-friendly systems to combat alert fatigue. The findings hold promise for global implementation, with potential applicability to other healthcare systems and ICUs.
January 24, 2024