MONDAY, March 4, 2019 (Pharmacist's Briefing) -- An iterative, multidimensional quality improvement (QI) effort can reduce interruptive drug-drug interaction (DDI) alerts, according to a study published in the March issue of Pediatrics.
Calvin C. Daniels, Pharm.D., Ph.D., from St. Jude Children's Research Hospital in Memphis, Tennessee, and colleagues implemented a multidimensional approach, including an interdisciplinary advisory group, alert metrics, and measurement of perceived clinical value, to reduce the number of low-value interruptive DDI alerts. To identify DDI alerts for refinement, alert data were categorized into drug classes and analyzed. The researchers implemented refinement strategies including alert suppression and modifying alerts to be contextually aware.
Based on historical analysis of classified DDI alerts, 26 alert refinements were implemented; these refinements represented 47 percent of all alerts. The researchers found substantial decreases in the number of interruptive DDI alerts as a result of alert refinement efforts: 40 percent for all clinicians (22.9 to 14 per 100 orders) and up to 82 percent for attending physicians (6.5 to 1.2 per 100 orders). During the project period, two patient safety events that were related to alert refinements were reported.
"We demonstrated that multiple alert-refinement methods within a single QI effort decreased DDI alert frequency," the authors write. "Further research on easily obtainable alert metrics that provide a clear understanding of alert value and clinician responses will help to improve the efficiency of future alert-improvement efforts."