The Hidden Threat of Drug-Related Problems
By John Horn, PharmD, professor of pharmacy, University of Washington School of Pharmacy, Seattle.
Drug-related problems (DRPs) are an “unspoken pandemic.” Serious DRPs are directly responsible for 6-10% of hospitalizations. About 25% of the population will suffer from at least one serious DRP during their lifetime, ending up with severe morbidity, hospitalization, or even mortality.
Although DRPs are often associated with the elderly population and the concomitant use of several medications, DRPs can occur while taking a single medication at any age.
Typically, medications are prescribed for specific indications with the benefit substantially outweighing the risk associated with the treatment. This risk-benefit ratio can be altered by several factors including the following:
(1) Patient-drug interactions – Some people can suffer serious and even fatal reactions to their medications due to individual vulnerability to develop serious adverse effects or lack of drug efficacy. The patient-specific factors that govern such outcomes include diet, genetic profile, smoking status, lab results, and concurrent disease states, among others.
(2) Drug-drug interactions – When patients are exposed to more than one drug, an interaction between the drugs may occur and can often be very serious. A common example is where one medication substantially increases or decreases the concentration of another medication in the body. Combinations of drugs can also lead to an increased toxic effect (e.g., hypotension, hypoglycemia, hyperkalemia), a synergistic harmful effect of medications on various body organs/functions (e.g., blood pressure, cardiac rhythm, bone marrow suppression, cognitive functions) and/or reduce the therapeutic effect of one or both drugs.
The emergence of serious DRPs in patients is often linked to the lack of appropriate alerting of clinicians to the potential risks. With the large number of drug therapies available, healthcare providers need assistance to assess potential DRPs and relevant management options.
Legacy DRP alerting software solutions cannot adapt their alerts based on patients’ specific characteristics. This results in large numbers of inappropriate alerting (false positive alerts), which cause providers to ignore nearly all alerts, including those that are truly important for patient safety. Furthermore, legacy systems’ inability to consider multiple factors that affect the risk to a patient of a potential DRP is also responsible for lack of necessitated alerting.
What is the solution to inappropriate alerting and the alert fatigue it causes? An alerting platform that considers individual patient data and executes complex algorithms that can differentiate between patients at risk of developing serious DRPs and those at low risk. This patient-specific approach to DRP alerting results in fewer, more accurate alerts. A recent scientific publication highlights the benefits of such an innovative platform for handling DRPs – Seegnal. Unlike any other existing tools, it incorporates relevant data and personalizes alerting, while generating twenty-fold better accuracy and 94% fewer alerts compared to legacy solutions. Using this approach, Seegnal enables clinicians to effectively detect, prioritize, and resolve DRPs in seconds. It’s a true lifesaver in the most literal sense of the word.