• Tinka Bakker, Ameen Abu-Hanna, Dave A Dongelmans, Wytze J Vermeijden, Rob J Bosman, Dylan W de Lange, Joanna E Klopotowska, Nicolette F de Keizer, SIMPLIFY study group, S Hendriks, J Ten Cate, P F Schutte, D van Balen, M Duyvendak, A Karakus, M Sigtermans, E M Kuck, N G M Hunfeld, H van der Sijs, P W de Feiter, E-J Wils, P E Spronk, van KanH J MHJMDepartment of Clinical Pharmacy, Gelre Hospitals, Apeldoorn, The Netherlands., M S van der Steen, I M Purmer, B E Bosma, H Kieft, R J van Marum, E de Jonge, A Beishuizen, K Movig, F Mulder, FranssenE J FEJFOLVG Hospital, Department of Clinical Pharmacy, Amsterdam, The Netherlands., W M van den Bergh, W Bult, M Hoeksema, and E Wesselink.
• Amsterdam UMC (location AMC), Department of Medical Informatics, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands. Electronic address: t.bakker1@amsterdamumc.nl.
• J Crit Care. 2021 Apr 1; 62: 124-130.

PurposePotential drug-drug interactions (pDDIs) may harm patients admitted to the Intensive Care Unit (ICU). Due to the patient's critical condition and continuous monitoring on the ICU, not all pDDIs are clinically relevant. Clinical decision support systems (CDSSs) warning for irrelevant pDDIs could result in alert fatigue and overlooking important signals. Therefore, our aim was to describe the frequency of clinically relevant pDDIs (crpDDIs) to enable tailoring of CDSSs to the ICU setting.Materials & MethodsIn this multicenter retrospective observational study, we used medication administration data to identify pDDIs in ICU admissions from 13 ICUs. Clinical relevance was based on a Delphi study in which intensivists and hospital pharmacists assessed the clinical relevance of pDDIs for the ICU setting.ResultsThe mean number of pDDIs per 1000 medication administrations was 70.1, dropping to 31.0 when considering only crpDDIs. Of 103,871 ICU patients, 38% was exposed to a crpDDI. The most frequently occurring crpDDIs involve QT-prolonging agents, digoxin, or NSAIDs.ConclusionsConsidering clinical relevance of pDDIs in the ICU setting is important, as only half of the detected pDDIs were crpDDIs. Therefore, tailoring CDSSs to the ICU may reduce alert fatigue and improve medication safety in ICU patients.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

12 keywords...

hide…