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Table 5 CDSS notifications assessed as relevant but confirmed as non-relevant

From: The support of medication reviews in hospitalised patients using a clinical decision support system

DRP notifications Reason scored as non-relevant Action needed to improve algorithm
Renal failure and Rosuvastatin: contra-indicated in renal failure Renal function was 14 ml/min with a daily dose of 10 mg Rosuvastatin, which is acceptable when the dosage is slowly increased Introduce Rosuvastatin dosage limits of renal dysfunction into the algorithm as well as start date of prescription
Metformin and unknown vitamin B12 level Vitamin B complex is prescribed. Vitamin B12 levels are regarded as irrelevant when supplemented Prescription of vitamin B complex should be included in the algorithm. Furthermore, determined vitamin B12 levels should also be included in the algorithm
Tramadol and seizure: Tramadol should be used with caution in patients with a history of epilepsy and those on concomitant seizure threshold-lowering medication. Consider switching to other pain medication Tramadol is contraindicated in epilepsy, associated drugs (nortriptyline) is prescribed for depression Nortriptyline should be removed from the algorithm since this is not a standard therapy for epilepsy
Renal Failure and pregabalin: initial dose 75 mg per day, maximum dose 300 mg per day Renal function of 43 ml/min with a dosage of 150 mg daily. Maximum dose was not exceeded The algorithm should be adjusted to take into account the starting date of the prescription
Anticoagulation therapy and INR: acenocoumarol High INR, but already given anti-dote vitamin K Include the prescription of the anti-dote vitamin K into the algorithm
Use of acetosal, dipyridamol, clopidogrel, prasugrel without a HMG CoA-reductase inhibitor therapy (statin) Patients were considered too old of age for HMG CoA-reductase inhibitor therapy A frailty indicator might be considered for inclusion to determine if a HMG CoA-reductase inhibitor therapy should still be prescribed