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Appl Clin Inform 2021; 12(02): 199-207
DOI: 10.1055/s-0041-1722916
Review Article

A Narrative Review of Clinical Decision Support for Inpatient Clinical Pharmacists

Liang Yan
1   University of Utah College of Pharmacy, University of Utah Health, Salt Lake City, Utah, United States
,
Thomas Reese
2   Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah, United States
,
Scott D. Nelson
3   Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
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Abstract

Objective Increasingly, pharmacists provide team-based care that impacts patient care; however, the extent of recent clinical decision support (CDS), targeted to support the evolving roles of pharmacists, is unknown. Our objective was to evaluate the literature to understand the impact of clinical pharmacists using CDS.

Methods We searched MEDLINE, EMBASE, and Cochrane Central for randomized controlled trials, nonrandomized trials, and quasi-experimental studies which evaluated CDS tools that were developed for inpatient pharmacists as a target user. The primary outcome of our analysis was the impact of CDS on patient safety, quality use of medication, and quality of care. Outcomes were scored as positive, negative, or neutral. The secondary outcome was the proportion of CDS developed for tasks other than medication order verification. Study quality was assessed using the Newcastle–Ottawa Scale.

Results Of 4,365 potentially relevant articles, 15 were included. Five studies were randomized controlled trials. All included studies were rated as good quality. Of the studies evaluating inpatient pharmacists using a CDS tool, four showed significantly improved quality use of medications, four showed significantly improved patient safety, and three showed significantly improved quality of care. Six studies (40%) supported expanded roles of clinical pharmacists.

Conclusion These results suggest that CDS can support clinical inpatient pharmacists in preventing medication errors and optimizing pharmacotherapy. Moreover, an increasing number of CDS tools have been developed for pharmacists' roles outside of order verification, whereby further supporting and establishing pharmacists as leaders in safe and effective pharmacotherapy.

Keywords

clinical decision support - pharmacy information systems - inpatient care - pharmacy - clinical informatics - pharmacist

Protection of Human and Animal Subjects

There were no human subjects involved in this project.




Publication History

Received: 25 August 2020

Accepted: 14 December 2020

Article published online:
17 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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