5PSQ-116\u2005Analysis and evaluation of a renal function-based dosage adjustment system at a university hospital

Abstract

Background Renal insufficiency is relatively common among hospitalised patients, and is associated with an increase in hospitalisation-related morbidity and mortality. Drug-dosing errors are common in patients with renal impairment and can cause adverse effects and poor outcomes. Purpose The purpose of this study was to evaluate the benefit of the Renal Function Based Dosage Adjustment System in a tertiary hospital. Material and methods This was a single institutional, retrospective pre/post study conducted over 3\u2009month periods within 9 years. In August 2006, the Renal Function Based Dosage Adjustment System which monitored drug prescription and generated a real-time alerting window, was implemented and has operated well in a tertiary hospital in Korea. We analysed prescription and alert data of the tertiary hospital’s Healthcare Information System and compared the pre-renal dosing system versus the post-renal dosing system from April to June 2006, 2007 and 2015. Results Among the patients whose admission and discharge periods were included during the study period, 7587 patients with an estimated glomerular filtration rate of less than 60 and who required dose adjustment according to the patient’s renal function. The rate of inappropriate prescription was 8.7% in 2006, 7.4% in 2007 and 2.7% in 2015. The drug classes that most frequently generated alerts were the H2 blocker (44.2% in early clinical decision support system (CDSS) period, 52.8% in the late CDSS period) and antimicrobials (17.0% in the early CDSS period, 52.8% in the late CDSS period). Conclusion The current system may be practically useful in the improvement of safety in renal-insufficient patients resulting in the realisation of effective pharmacotherapy. To improve the clinical acceptance of alerts, this system should strive to maximise the effectiveness of alerts/minimise over-alerting. References and/or acknowledgements Authors of this presentation have the following to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation: Kyung Suk Choi: Nothing to disclose. Eunsook Lee: Nothing to disclose. Sandy Jeong Rhie: Nothing to disclose. No conflict of interest.