American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2025
Impact of using dosing criteria to refine pharmacogenomic clinical decision support for tricyclic antidepressants.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Massmann Amanda, Petry Natasha, Mills Sarah, Adjekum Adwoa, Van Heukelom Joel
Аннотация
PURPOSE: To evaluate the impact of dose-specific logic for tricyclic antidepressant (TCA) pharmacogenomics (PGx) clinical decision support (CDS). We aimed to provide guidance in an area with limited supporting literature, ensure optimal dosing through CDS, and limit alert fatigue. The primary outcome was the reduction in alerts prescribers encountered, while the secondary outcome included an analysis across specialties.
METHODS: A retrospective chart review was conducted to examine TCA PGx CDS before and after implementation of dosing criteria for alerts. Data were abstracted from the electronic medical record. A χ2 test was performed to analyze the frequency of alerts in behavioral health and other specialties.
RESULTS: In the cohort lacking dose criteria, most TCA orders were for indications other than depression (76%) and guidelines would not apply to the majority of these orders. Using dosing criteria to refine CDS reduced the volume of TCA alerts by 74.8%. Alert volume decreased the most in specialties other than behavioral health due to prescriptions for indications other than anxiety or depression (P = 0.035).
CONCLUSION: Dose-centric alerts may be used as a strategy to achieve optimal dosing. Alerting clinicians when dose modifications should occur contributes to getting the right dose to the right patient. Future efforts should focus on optimal dosing of medication through CDS enhancements.
METHODS: A retrospective chart review was conducted to examine TCA PGx CDS before and after implementation of dosing criteria for alerts. Data were abstracted from the electronic medical record. A χ2 test was performed to analyze the frequency of alerts in behavioral health and other specialties.
RESULTS: In the cohort lacking dose criteria, most TCA orders were for indications other than depression (76%) and guidelines would not apply to the majority of these orders. Using dosing criteria to refine CDS reduced the volume of TCA alerts by 74.8%. Alert volume decreased the most in specialties other than behavioral health due to prescriptions for indications other than anxiety or depression (P = 0.035).
CONCLUSION: Dose-centric alerts may be used as a strategy to achieve optimal dosing. Alerting clinicians when dose modifications should occur contributes to getting the right dose to the right patient. Future efforts should focus on optimal dosing of medication through CDS enhancements.