[Efficacy of decision support systems to improve medication safety - results of the evaluation of the "Arzneimittelkonto NRW"]

Abstract

Polypharmacy increases the risk of adverse drug reactions, especially in the elderly. Therefore, the reduction of potentially inadequate medication (PIM), an improvement in drug therapy safety and, in general, a more rational use of drugs is an objective of various interventions. The aim of this prospective single-arm interventional study is to investigate the potential of a decision support system (DSS; "Arzneimittelkonto NRW") to improve medication safety in outpatient care. 15 primary care physicians participating in the study recruited 874 patients. Prescription data and results of medication safety tests were available for 654 patients. Data of at least 12 months were available for 86% of these patients. PIM prevalence declined within 12 months (-11.3%), but not at a statistically significant level. The number of prescriptions after the introduction of the DSS is significantly below the prescription volume before the introduction of the DSS (-14.1%). Constantly high alteration rates of up to 85% were observed, for example, on drug interaction system warnings made by the DSS. Technical decision support systems have the potential to support a safer and cost-saving drug use. For the first time, this pilot study provides evidence for this in the context of standard outpatient care in Germany. However, further investigations are necessary to establish a robust body of evidence. A particular focus should be on the qualitative monitoring of the studies and the involvement of other actors in the care process.

Keywords: Arzneimitteltherapiesicherheit; Decision support systems; Entscheidungsunterstützende Systeme; Information technology; Informationstechnologie; Medication safety; Potentially inadequate medication; Potenziell inadäquate Verschreibungen.