Skip to main content

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