Drug-Drug Interaction Clinical Decision Support Conference Series

说明（由申请人提供）：药物是预防和治疗许多疾病所必需的。美国人平均每年收到12张处方，65岁及以上的人每年收到30多张处方。这种程度的药物使用产生了潜在的药物-药物相互作用（ddi）。由已知的DDI引起的伤害是一种可预防的药物不良事件和严重的用药错误。有证据表明，每年有数亿种相互作用的药物被共同开出处方，最终使数亿患者暴露于这些已知的危险之中。虽然与ddi相关的确切危害程度尚不清楚，但会发生临床显著的相互作用，导致潜在的危及生命的后果。电子处方和药房信息系统包括DDI警报，作为临床决策支持（CDS）的一种形式，以警告处方者和药剂师可能有害的药物组合，并向他们提供必要的信息，以避免或减轻患者伤害的风险。今天，每个药房，很快每个医生办公室和卫生保健组织都将采用某种形式的健康信息技术，其中包括DDI警报。然而，使用这项技术来改善患者安全并没有达到它的承诺。特别是，研究表明，“目前的DDI警报系统已经崩溃。”此应用程序要求对面向解决方案的系列会议提供部分支持，这些会议旨在改进CDS中有意义的DDI警报的实现。长期目标是制定一个持续的结构化过程，以提高卫生服务提供者使用的DDI警报系统的质量，最大限度地发挥这项技术的价值，并最终改善患者安全。在这些会议上，专家、利益相关者和公私合作伙伴将制定战略，对ddi进行明确、系统的评估，以改善知识库数据和电子临床决策辅助的实际应用。该系列会议的具体目标是：1)制定对DDI证据进行系统评估的指南；2)建议将ddi纳入药品安全警报的原则；3)建立DDI警报的首选策略。总之，这个应用程序将解决一个重要的公共卫生问题，即提高卫生信息技术作为卫生保健安全网，并将最终在全国范围内改善药物使用和患者安全。

DESCRIPTION (provided by applicant): Medications are essential to preventing and treating many illnesses. Americans receive an average of 12, and those aged 65 years and older receive more than 30 prescriptions each year. This degree of medication use creates the potential for drug-drug interactions (DDIs). Injury due to a known DDI is a preventable adverse drug event and serious medication error. Evidence suggests that hundreds of millions of interacting drugs are co-prescribed each year, ultimately exposing hundreds of millions of patients to these known hazards. Although the exact magnitude of harm associated with DDIs is not known, clinically significant interactions occur, resulting in potentially life-threatening consequences. Electronic prescribing and pharmacy information systems include DDI alerts as a form of clinical decision support (CDS) to warn prescribers and pharmacists of potentially harmful medication combinations, and provide them with necessary information to avoid or mitigate the risk of patient harm. Today, every pharmacy and soon every physician office and health care organization will employ some form of health information technology that will include DDI alerts. However, use of this technology to improve patient safety has not lived up to its promise. In particular, research has shown "the current DDI alert system is broken." This application requests partial support for a solution-oriented conference series aimed at improving the implementation of meaningful DDI alerts within CDS. The long- term goals are to develop an ongoing structured process to improve the quality of DDI alerting systems used by health providers to maximize the value of this technology, and ultimately improve patient safety. At these conferences, experts, stakeholders, and public-private partnerships will develop strategies for explicit, systematic evaluation of DDIs to improve knowledge base data and the practical utility of electronic clinical decision aids. Specific aims of the conference series are to: 1) develop guidelines for systematic appraisal of DDI evidence; 2) recommend principles for including DDIs in drug safety alerts; and 3) establish preferred strategies for presenting DDI alerts. In summary, this application will address an important public health issue regarding improving health information technology as a healthcare safety net, and will, ultimately lead to improved medication use and patient safety throughout the nation. PUBLIC HEALTH RELEVANCE: Hundreds of millions of potential drug interactions occur every year, affecting millions of patients. Drug interactions can be prevented and breakdowns in the healthcare system are to blame for many of these serious, and sometimes deadly, medical errors. This project will conduct four meetings with national and international experts to design better systems to prevent drug interactions, resulting in improved patient safety and health for all Americans.