title: [Effect of modal computer-based alerts on the prescription of valproic acid and meropenem].
abstract: OBJECTIVE
  To analyze the effect of modal computer-based alerts on the concomitant prescription of valproic acid (VPA) and meropenem.
  
  
  METHODS
  Analytical intervention study conducted in a tertiary hospital for eleven months. Hospitalized patients with a diagnosis of epilepsy and treated with VPA and meropenem in concomitant therapy were included. In the computerized prescription order entry software an automatic non-modal alert was reconverted to a modal one. This was triggered when the physician introduced VPA and meropenem together in the same prescription. To measure the effect of this alert the prescription habits were compared with a previous period in which the alert was not modal.
  
  
  RESULTS
  Modal computer-based alert modified the prescription habit by reducing the number of patients with concomitant treatment from 13 to 4 (P=.046). However, it was notable that the number of requests for VPA serum levels decreased, and the average number of concomitant days of treatment rose from 4.7 to 8.75 in those patients in which none of the drugs was suspended.
  
  
  CONCLUSIONS
  The implementation of modal computer-based alerts reduces patient exposure to concomitant treatment with meropenem and VPA.
authors.affiliation: Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: mvelez.hrc@salud.madrid.org.
authors.forename: M
authors.initials: M
authors.lastname: Vélez-Díaz-Pallarés
authors.affiliation: Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: N
authors.initials: N
authors.lastname: Vicente-Oliveros
authors.affiliation: Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Delgado-Silveira
authors.affiliation: Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Pérez-Menéndez-Conde
authors.affiliation: Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Álvarez-Díaz
authors.affiliation: Servicio de Farmacia, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: T
authors.initials: T
authors.lastname: Bermejo-Vicedo
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy; D004347:Drug Interactions; D004360:Drug Therapy, Computer-Assisted / Q000706:statistics & numerical data; D055695:Electronic Prescribing; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control* / Q000706:statistics & numerical data; D008297:Male; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data; D000077731:Meropenem; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D062606:Tertiary Care Centers; D013845:Thienamycins / Q000627:therapeutic use*; D014584:User-Computer Interface; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D013845:Thienamycins; D014635:Valproic Acid; D000077731:Meropenem
keywords: Alerta interactiva modal; Computer-based alerts; Drug interaction; Interacción; Meropenem; Valproic acid; Ácido valproico