5PSQ-097 Triple whammy interaction: improving patients’ safety

Alzueta, Natalia; Celaya, MC; Acin, MT; Echeverria, Amaya; Fontela, Carmen; Sanz, L. Calvo; Gomez, N Garcia; Fernandez, ML; Lopez, A Zurutuza; Garjón, Javier

doi:10.1136/ejhpharm-2019-eahpconf.530

Cited by 2 publications

(3 citation statements)

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“…In a scoping review, the clinical validation of several CDSSs for drug-related problems revealed a sensitivity of 28%–85% and a specificity of 42–75% [ 36 ], though these were not studies of CDSS for TW management. A general acceptance rate above 60% is suggested for action-oriented interventions [ 37 ]; our TW algorithm compliance rate was 77.7%, which compares favourably with this standard and with the acceptance rates reported for primary care TW CDSSs (30–82%) [ 26 , 28 , 29 ]. The acceptance rate differed between the alerts and was highest within patients with a kidney function below 30 ml/min/1.73m2.…”

Section: Discussionsupporting

confidence: 71%

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Evaluation of Triple Whammy Prescriptions After the Implementation of a Drug Safety Algorithm

Dahmke,

Schelshorn,

Fiumefreddo

et al. 2024

Drugs - Real World Outcomes

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Background and Objective The term triple whammy (TW) refers to the concomitant use of non-steroidal anti-inflammatory drugs, diuretics, and angiotensin system inhibitors; this combination significantly increases the risk of acute kidney injury (AKI). To prevent this serious complication, we developed an electronic algorithm that detects TW prescriptions in patients with additional risk factors such as old age and impaired kidney function. The algorithm alerts a clinical pharmacist who then evaluates and forwards the alert to the prescribing physician. Methods We evaluated the performance of this algorithm in a retrospective observational study of clinical data from all adult patients admitted to the Cantonal Hospital of Aarau in Switzerland in 2021. We identified all patients who received a TW prescription, had a TW alert, or developed AKI during TW therapy. Algorithm performance was evaluated by calculating the sensitivity and specificity as a primary endpoint and determining the acceptance rate among clinical pharmacists and physicians as a secondary endpoint. Results Among 21,332 hospitalized patients, 290 patients had a TW prescription, of which 12 patients experienced AKI. Overall, 216 patients were detected by the alert algorithm, including 11 of 12 patients with AKI; the algorithm sensitivity is 88.3% with a specificity of 99.7%. Physician acceptance was high (77.7%), but clinical pharmacists were reluctant to forward the alerts to prescribers in some cases. Conclusion The TW algorithm is highly sensitive and specific in identifying patients with TW therapy at risk for AKI. The algorithm may help to prevent AKI in TW patients in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s40801-023-00405-y.

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Section: Discussionsupporting

confidence: 71%

“…As such, this risky drug combination is often not detected by conventional CDSSs. Several specific algorithms have been developed for primary care [ 26 – 30 ]. Notably, like many drug-drug interactions, a TW prescription is not strictly contraindicated.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Triple Whammy Prescriptions After the Implementation of a Drug Safety Algorithm

Dahmke,

Schelshorn,

Fiumefreddo

et al. 2024

Drugs - Real World Outcomes

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show abstract

“…Siguiendo este rumbo, en el Servicio Navarro de Salud-Osasunbidea (SNS-O) se han abordado por múltiples vías los riesgos de los AINE y la desprescripción de benzodiacepinas. Se han empleado boletines 8 , 9 , acciones formativas, alertas en la receta electrónica 10 e información para pacientes 11 .…”

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Health-System Pharmacy services for outpatients are evolving

Garjón Parra,

Sanz Álvarez

2023

An Sist Sanit Navar

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5PSQ-097 Triple whammy interaction: improving patients’ safety

Cited by 2 publications

References 0 publications

Evaluation of Triple Whammy Prescriptions After the Implementation of a Drug Safety Algorithm

Evaluation of Triple Whammy Prescriptions After the Implementation of a Drug Safety Algorithm

Health-System Pharmacy services for outpatients are evolving

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