ABSTRACT
Using a two-period group randomized study, we tested whether a technology assisted pharmacist intervention improved physician adherence to coronary heart disease (CHD) secondary prevention medication guidelines. After an observation period, physician practices were randomized to intervention or control arms. In the intervention arm, alerts prompted a pharmacist to communicate with the responsible physician about secondary prevention medications. The intervention significantly improved the proportion of patients discharged on appropriate secondary prevention medications.
Subject(s)
Coronary Disease/drug therapy , Drug Therapy, Computer-Assisted , Guideline Adherence , Hospitals, Community , Humans , Practice Guidelines as Topic , Practice Patterns, Physicians' , Reminder Systems , Secondary PreventionABSTRACT
Due to increasing reports of spironolactone associated life-threatening hyperkalemia, we implemented a rule in our automated event detection system to monitor serum potassium results in patients receiving spironolactone. In 2004, 419 (10.49%) of 3995 admissions at 3 BJC HealthCare hospitals were identified as having hyperkalemia while on spironolactone. For a 9-month period in one facility, 33 of 52 automatically detected potential ADEs had been validated by pharmacists through manual chart review to have spironolactone as a contributing factor (PPV=63.5%).
