Tailoring a computerized decision support system (CDSS) to the ICU environment significantly reduced the number of high-risk drug combinations administered to ICU patients, according to a study led by Amsterdam UMC, conducted in nine Dutch intensive care units (ICU) and published on Jan. 20 in The Lancet.
In addition to the lower rate of high-risk drug combinations, it “also improved monitoring ICU patients when avoiding such combinations was not possible, and reduced the length of patients’ stay in the ICU.”
CDSSs “are used to alert ICU physicians about potentially risky drug combinations…through alerts describing drug prescribing.” These systems, however, are usually not specifically tailored to an ICU environment, “leading to an abundance of alerts that are not clinically relevant, which causes alert fatigue. Research shows that more than 80% of alerts for potentially risky drug combinations are dismissed by ICU physicians.”
Tailoring the CDSSs to the specific ICU environment showed a 12% reduction in high-risk drug combinations being administered to ICU patients, “and the monitoring of possible side-effects pertaining to high-risk drug combinations was improved. Patients’ stay[s] in the ICU [were] also shortened.”
The study demonstrates that tailoring the CDSS to the ICU environment improves patient safety by “alerting only where it matters,” doing away with unnecessary alerts. According to Amsterdam UMC, “these adjustments [to the CDSSs] can be made manually in the existing systems and require minimal effort.” The researchers also published two lists – one listing drug combinations that are high-risk in the ICU for which alerts should be enabled, and another listing low-risk drug combinations that do not require alerts.”
Amsterdam UMC’s website has the release.