NCT05923983

DETECT-IP: a Clinical Decision Support System and Intelligent Procedures to Counter Some Adverse Drug Events in Older Hospital Patients

Reduction of Acute Renal Failure and/or Hyperkaliemia Adverse Drug Events in Older Inpatients by Incorporating Specific Rules Into a Computerized Support System and Dedicated Procedures: a Randomized Trial.

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 783 (actual)
• Sponsor: University Hospital, Lille · Academic / Other
• Sex: All
• Age: 65 Years
• Healthy volunteers: Not accepted

Summary

Current evidence shows that computerized decision support systems (CDSS) have shown to be insufficiently effective to prevent adverse drug reactions (ADRs) at large scale (e.g. whole hospital). Several barriers for successful implementation of CDSS have been identified: over-alerting, lack of specificity of rules, and physician interruption during prescription. The effectiveness of CDSS could be increased in two ways. Firstly, by creating rules that are more specific to a given adverse drug reaction: the current study focuses on acute renal failure and hyperkalemia (two serious and frequent ADR in older hospitalized patients). Secondly, by involving the pharmacist in the review of the alerts so that he/she can transmit, if deemed necessary, a pharmaceutical recommendation to the clinician. This procedure will reduce over-alerting and prevent task interruption. The hypothesis is that the use of specific rules created by a multidisciplinary team and implemented in a CDSS, combined with a strategy for managing and transmitting alerts, can reduce specific ADRs such as hyperkalemia and acute renal failure.

Conditions

• Patient Acceptance of Health Care
• Acute Renal Failure

Interventions

Type	Name	Description
OTHER	Clinical decision support	In the intervention group, the pharmaceutical validation will be based on routine care, often on entry to a ward and by analysis of all the alerts produced by the CDSS. Some alerts will result in a pharmaceutical intervention being provided to the medical team
OTHER	Will not receive Clinical Decision Support	In the control group, the pharmaceutical validation will be based on routine care, often on entry to a ward or in a particular situation

Timeline

• Start date: 2023-10-02
• Primary completion: 2024-10-03
• Completion: 2024-10-03
• First posted: 2023-06-29
• Last updated: 2025-12-26

Locations

1 site across 1 country: France