title: Computerized pharmacy surveillance and alert system for drug-related problems.
abstract: OBJECTIVE
  Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment. Most of these applications have utilized a small range of drugs with alerts and/or types of alert. The objective of this study was to describe the implementation of a PWS integrated in the electronic medical record (EMR).
  
  
  METHODS
  The PWS was developed in 2003-2004. Pharmacological information to generate drug alerts was entered on demographic data, drug dosage, laboratory tests related to the prescribed drug and drug combinations (interactions, duplications and necessary combinations). The PWS was applied in the prescription reviews conducted in patients admitted to the hospital in 2012.
  
  
  CONCLUSIONS
  Information on 83% of the drugs included in the pharmacopeia was introduced into the PWS, allowing detection of 2808 potential DRPs, representing 79·1% of all potential DRPs detected during the study period. Twenty per cent of PWS DRPs were clinically relevant, requiring pharmacist intervention.
  
  
  CONCLUSIONS
  The PWS detected most potential DRPs, thus increasing inpatient safety. The detection ability of the PWS was higher than that reported for other tools described in the literature.
authors.affiliation: Services of Hospital Pharmacy, Hospital Universitari del Mar, Barcelona, Spain.|Escola Superior d'Infermeria del Mar, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Ferrández
authors.affiliation: Services of Hospital Pharmacy, Hospital Universitari del Mar, Barcelona, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Urbina
authors.affiliation: Services of Hospital Pharmacy, Hospital Universitari del Mar, Barcelona, Spain.|Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Grau
authors.affiliation: Services of Hospital Pharmacy, Hospital Universitari del Mar, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Mateu-de-Antonio
authors.affiliation: Services of Hospital Pharmacy, Hospital Universitari del Mar, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Marin-Casino
authors.affiliation: Department of Informatics, Hospital Universitari del Mar, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Portabella
authors.affiliation: Department of Statistics, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Mojal
authors.affiliation: Epidemiologia i Salut Pública, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Riu
authors.affiliation: Services of Hospital Pharmacy, Hospital Universitari del Mar, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Salas
mesh_terms: D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000517:prevention & control*; D061214:Patient Safety; D010595:Pharmacists
keywords: alerts; computerized prescriber order entry; drug-related problem; pharmacy warning system; prescription review