Key result
Implementation of a real-time clinical surveillance tool reduced the oral anticoagulant adverse drug event ratio from 0.69% before implementation to 0.41% after implementation (P < 0.001).
Why the study?
The effect of implementing a real-time clinical surveillance tool on the occurrence of oral anticoagulant adverse drug events in a large health system was unknown.
Does implementation of a real-time clinical surveillance tool reduce oral anticoagulant adverse drug events in patients receiving oral anticoagulants?
Observational (n=56,761)
Yes
Does implementation of a real-time clinical surveillance tool reduce oral anticoagulant adverse drug events in patients receiving oral anticoagulants?
Implementation of a real-time clinical surveillance tool with pharmacist alerts significantly reduced oral anticoagulant adverse drug events in a large health system.
Answers are grounded in this paper and cite their sources.
Associated with fewer oral anticoagulant adverse events; hypothesis-generating and requires randomized confirmation.
OBJECTIVE: The aim of the study was to determine the effect on occurrence of oral anticoagulant adverse drug events (ADEs) after implementation of a real-time clinical surveillance tool in a large health system. METHODS: Records of patients receiving an oral anticoagulant during a 6-month period before and after implementation of a real-time clinical surveillance tool were reviewed for 31 hospitals within a nationwide health system. The real-time clinical surveillance tool analyzed clinical data from the electronic medical record and alerted the pharmacist of potential opportunities for patient clinical intervention. Oral anticoagulant administration data, International Classification of Diseases, Ninth Edition code documentation of ADEs caused by oral anticoagulants, and alert notification data from the real-time clinical surveillance tool were evaluated. RESULTS: A total of 56,761 patients were included in the study. The oral anticoagulant ADE ratio decreased from 0.69% during the period before implementation of the real-time clinical surveillance tool to 0.41% during the period after implementation (P < 0.001). Most alert notifications and greatest impact on ADE ratio occurred in patients administered a single oral anticoagulant during hospitalization. CONCLUSIONS: Implementation of a real-time clinical surveillance tool prompting pharmacist intervention reduced the oral anticoagulant ADE ratio for the health system.
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Daniel et al. (2019) conducted an observational in Patients receiving oral anticoagulants (n=56,761). Real-time clinical surveillance tool vs. Period before implementation was evaluated on Occurrence of oral anticoagulant adverse drug events (ADEs) (p=< 0.001). Implementation of a real-time clinical surveillance tool reduced the oral anticoagulant adverse drug event ratio from 0.69% before implementation to 0.41% after implementation (P < 0.001).
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