Hospital Pharmacy最新文献

{"title":"The Implementation of a Clinical Decision Support System for Managing Drug-Disease Interactions in Outpatients with Cardiovascular and Diabetic Comorbidities: An Interventional Study at a Tertiary Hospital in Vietnam.","authors":"Hanh T H Nguyen, Thu Ha Vu, Ngoc Mai Vu Thi, Trong Hieu Le, Thu Huong Hoang Thi, Loan Tran Thi, Khanh Linh Doan Thi, Tuan Hieu Pham, Hai Le Ba, Thanh Hai Nguyen","doi":"10.1177/00185787261442157","DOIUrl":"https://doi.org/10.1177/00185787261442157","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effectiveness of a combined intervention consisting of a clinical decision support system (CDSS) integrated into the hospital information system (HIS) and pharmacist consultation in managing drug-disease interactions (DDSIs) among outpatients with cardiovascular disease (CVD) and diabetes mellitus (DM) comorbidities at a Tertiary Hospital in Vietnam.</p><p><strong>Methods: </strong>A pre- and post-interventional study was conducted using data from outpatient prescriptions and electronic medical records. The pre-intervention phase took place from May 1 to August 31, 2024, followed by the post-intervention phase from September 15, 2024, to January 15, 2025. Following the CDSS implementation in September 2024, clinical pharmacists performed interventions, which were prospectively documented. Descriptive statistics and comparative tests were used for data analysis.</p><p><strong>Results: </strong>Patient characteristics were comparable between two phases, with a mean age of 76 ± 8.5 years (pre-intervention phase) and 77 ± 7.5 years (post-intervention phase). After the intervention, the prevalence of absolute contraindication showed a statistically significant decrease (<i>P</i> < 0.05). The rate of relative contraindication plummeted from 0.33% to 0.01% (<i>P</i> < 0.05). Notably, relative contraindications involving bisoprolol - chronic obstructive pulmonary diseases and gliclazide-hepatic fibrosis - cirrhosis sharply reduced post-intervention (<i>P</i> < 0.001). \"Use with caution\" interactions also witnessed a decline from 0.20% to 0.13% (<i>P</i> < 0.05), most significantly for lisinopril/hydrochlorothiazide - gout (<i>P</i> < 0.001). Pharmacist interventions were largely fully accepted, except for a few gout-related cases that received partial acceptance. No interventions were rejected.</p><p><strong>Conclusions: </strong>The integration of CDSS into HIS and pharmacist interventions were associated with significantly reduced harmful DDSIs in high-risk CV-DM patients. This approach demonstrates the value of integrated clinical tools and multidisciplinary collaboration in optimizing medication safety in outpatient settings.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261442157"},"PeriodicalIF":0.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ibuprofen-Induced Pemphigus Vulgaris: A Case Report.","authors":"Pongpan Chaiyapak, Tippawan Siritientong","doi":"10.1177/00185787261435480","DOIUrl":"https://doi.org/10.1177/00185787261435480","url":null,"abstract":"<p><p>Pemphigus Vulgaris (PV) is a chronic autoimmune blistering disease. Although pharmacological agents, particularly those containing thiol groups, have been identified as precipitating factors, reports of non-thiol drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), causing PV remain limited. We report a case of a 41-year-old Myanmar female who developed generalized bullous eruptions, oral ulcers, and ocular pain after the concurrent use of ibuprofen and penicillin V. She presented with extensive cutaneous erosions complicated by sepsis and malnutrition. Although penicillin V was initially suspected, a causality assessment performed by a pharmacist using the Naranjo algorithm identified ibuprofen as the \"probable\" culprit of the reaction. This assessment is crucial for guiding subsequent therapeutic decisions. The patient was successfully managed with systemic corticosteroids, nutritional support, and antibiotics. Importantly, the exclusion of penicillin allergy allowed the use of piperacillin/tazobactam to effectively treat sepsis. This rare case of ibuprofen-induced PV highlights the critical role of pharmacists in performing adverse drug reaction assessments to accurately identify the causative agent, thereby enabling safe and effective therapeutic decision-making.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261435480"},"PeriodicalIF":0.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Optimization of Automated Dispensing Cabinet Profiling on Override Rates in the Emergency Department.","authors":"Jonathan Martinez Gines, Erika Dittmar, Tom Wolfel, Shivana Syne, Estela Trimino","doi":"10.1177/00185787261437404","DOIUrl":"https://doi.org/10.1177/00185787261437404","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Automated dispensing cabinets (ADCs) are widely used in emergency departments (EDs) to enable rapid access to medications. However, use of the override function, which bypasses pharmacist review, has been associated with medication errors and adverse drug events. This quality improvement initiative aimed to reduce unnecessary ADC overrides through implementation of ADC profiling and workflow optimization strategies while maintaining timely medication access in a high-acuity emergency department.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective, single-site, pre-post intervention quality improvement study was conducted at a 950-bed community hospital with a high-volume adult ED. The intervention consisted of a coordinated strategy implemented sequentially and included standardization of the ED ADC formulary, development of a harmonized override medication list limited to time-sensitive therapies, redesign of the electronic health record ordering interface to align with ADC inventory and clinical protocols, and multidisciplinary staff education. Data was collected during a 5-month pre-implementation period from September 2024 through January 2025 and a 3-month post-implementation period from February 2025 through April 2025. The primary outcome was the monthly override rate per ADC. Secondary outcomes included identification of frequently overridden medications and evaluation of medication workflow timing metrics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Emergency department override rates declined substantially following implementation. Monthly ED override rates decreased from a pre-intervention range of 12.21% to 16.35% to 1.65% in February 2025, 1.10% in March, and 0.90% in April. Cabinet-level override rates remained below the institutional benchmark of 3%, ranging from 1.2% to 6.8% (median 2.3%) during the first month post-implementation and subsequently 0.3% to 2.2% (median 1.2%) in March and 0.2% to 1.3% (median 0.9%) in April. Overrides involving high-risk medications, including opioids and anxiolytics, declined markedly following implementation. The mean time from medication order entry to pharmacist verification increased modestly from 11 to 13 minutes, and the mean time from pharmacist verification to medication removal increased from 52 to 55 minutes. Review of internal safety reporting systems and operational feedback did not identify medication delays or adverse events attributable to ADC profiling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Implementation of ADC profiling supported by formulary standardization, override governance, EHR workflow alignment, and multidisciplinary education significantly reduced override rates in a high-acuity emergency department. These findings demonstrate that pharmacist verification and override restrictions can be integrated into ED medication workflows without compromising timely medication access and provide a practical framework for improving medication-use safety processes in e","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261437404"},"PeriodicalIF":0.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Related Problems in Outpatient Prescriptions Across Different Levels of Care in Vietnam: A Multicentre Cross-Sectional Study in a Resource-Constrained Health System.","authors":"Thang Nguyen, Vy Thao Tran, Ly Truong Cam Nguyen, Suol Thanh Pham, Khanh Duy Dang","doi":"10.1177/00185787261435507","DOIUrl":"https://doi.org/10.1177/00185787261435507","url":null,"abstract":"<p><strong>Background: </strong>Drug-related problems (DRPs) are a common and largely preventable cause of medication-related harm in outpatient care. The risk is amplified in resource-constrained health systems, where high prescribing workload and limited clinical pharmacy capacity may compromise prescribing quality and medication use. Evidence on the burden and determinants of DRPs across different levels of care remains limited in many low- and middle-income countries, including Vietnam.</p><p><strong>Objectives: </strong>To estimate the prevalence and types of DRPs in outpatient health insurance prescriptions and to identify factors associated with DRP occurrence across facilities at different levels of care in Vietnam.</p><p><strong>Methods: </strong>A multicentre cross-sectional study was conducted using 969 adult outpatient health insurance prescriptions issued between 2023 and 2024 at one provincial general hospital and two district-level health centres. Prescriptions were systematically sampled and retrospectively assessed for DRPs using the national framework issued by the Vietnamese Ministry of Health, which is aligned with Pharmaceutical Care Network Europe concepts. DRPs were categorised into drug selection-related problems and dose- or administration-related problems. Multivariable logistic regression analysis was performed to examine patient-, prescription-, and facility-level factors associated with the presence of at least one DRP.</p><p><strong>Results: </strong>DRPs were identified in 612 prescriptions (63.2%). Dose- and administration-related problems predominated, with inappropriate timing of administration being the most frequent issue (52.5%). Prescriptions containing five or more medicines were significantly more likely to include DRPs than those with fewer medicines (adjusted odds ratio [aOR] 3.41; 95% confidence interval [CI] 2.46-4.72). Digestive system disease diagnoses were strongly associated with DRPs compared with cardiovascular diseases (aOR 11.96; 95% CI 5.27-27.14). Substantial facility-level variation was observed, with one district-level site showing markedly higher odds of DRPs than the provincial hospital (aOR 8.24; 95% CI 4.97-13.64).</p><p><strong>Conclusions: </strong>DRPs were highly prevalent in outpatient prescriptions and were largely driven by preventable dosing and administration issues. The pronounced variation across levels of care highlights inequities in outpatient medication safety and underscores the need for targeted, practice-oriented medication safety strategies and strengthened clinical pharmacy services, particularly in lower-resource district-level settings.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261435507"},"PeriodicalIF":0.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Glyburide Use During Pregnancy: A Real-World Study Based on the FAERS Database.","authors":"Xianyan Yan, Hunong Xiang, Jingzhong Ou, Li Pan, Xiaoyan Wang, Liping Liu, Yuanling Zhou, Yan Li, Ronghua Zhang, Yanping Wu","doi":"10.1177/00185787261433433","DOIUrl":"https://doi.org/10.1177/00185787261433433","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the adverse event profile and potential safety signals associated with glyburide use during pregnancy using data from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS).</p><p><strong>Methods: </strong>Data from FAERS (Q1 2015-Q1 2025) were analyzed. Pregnant cases and glyburide exposures were identified using standardized MedDRA terminology. Signal detection was conducted using the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS) algorithms.</p><p><strong>Results: </strong>A total of 284 712 pregnant women were included, among whom 164 used glyburide. Seventeen positive safety signals were detected. Hypoglycaemia neonatal, congenital anomaly in offspring, and maternal hypoglycaemia were consistent with drug labeling and previous reports. Additional newly identified signals included caesarean section, placenta praevia, amniotic fluid volume decreased, blood creatinine increased, hypoxia, metabolic acidosis, umbilical cord abnormality, and others. At the system organ class (SOC) level, positive signals were observed for metabolism and nutrition disorders, endocrine disorders, and pregnancy, puerperium and perinatal conditions.</p><p><strong>Conclusion: </strong>This real-world FAERS-based analysis suggests that glyburide use during pregnancy may be associated with various adverse metabolic and pregnancy-related outcomes. Caution is warranted when prescribing glyburide for patients with HIP, with particular attention to monitoring placental function and neonatal glucose levels. Further prospective studies are needed to validate these findings.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261433433"},"PeriodicalIF":0.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Assessment of Automation Models in Hospital Pharmacy: Systematic Review of Technologies, Practices, and Clinical Impacts\".","authors":"K Lakshmi Kala, Puneet Sudan","doi":"10.1177/00185787261435535","DOIUrl":"https://doi.org/10.1177/00185787261435535","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261435535"},"PeriodicalIF":0.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an Integrated Clinical Decision Support System and Clinical Pharmacist-Led Interventions in Domperidone Prescribing: A 10-Year Interrupted Time Series Study.","authors":"Nguyen Thi Thu Phuong, Dao Thuy Duong, Tran Van Anh, Nguyen Duc Long, Le Duc Anh, Hoang Van Dung, Tran Thi Ngan","doi":"10.1177/00185787261433442","DOIUrl":"https://doi.org/10.1177/00185787261433442","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Domperidone is widely prescribed for gastrointestinal motility disorders and nausea-vomiting but is associated with serious cardiac adverse events, leading to regulatory restrictions on its indications, dosage, and duration. However, passive regulatory notifications alone often fail to translate into safer real-world prescribing practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the long-term real-world effectiveness of an integrated prescribing clinical decision support system (CDSS) combined with clinical pharmacist-led interventions in improving the safety and appropriateness of domperidone prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 10-year interrupted time series (ITS) study was conducted including all 51 437 inpatient and outpatient domperidone prescriptions issued between June 2015 and December 2025 at a large tertiary hospital in Vietnam. Sequential interventions were implemented: real-time CDSS alerts for contraindicated drug-drug interactions and daily maximum dose exceedance combined with pharmacist-led audit-feedback targeting dose errors (April 2021), updating the interaction database and pharmacist-led audit-feedback interventions targeting drug-drug interactions (January 2022), and pharmacist-led educational and audit-feedback interventions targeting treatment duration (September 2023). Monthly prescribing error rates were analyzed using segmented quasi-binomial regression with Newey-West robust standard errors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Prior to intervention, prescribing errors exhibited significant increasing baseline trends for contraindicated drug-drug interactions and maximum daily dose exceedance, whereas prolonged treatment duration errors showed a gradual but significant decreasing trend (&lt;i&gt;P&lt;/i&gt; &lt; .001). CDSS implementation alone was associated with a transient increase in contraindicated drug-drug interactions, followed by a significant reversal in trend. Subsequent pharmacist-led active monitoring resulted in a marked and clinically meaningful reduction in contraindicated interaction errors (trend change OR 0.810; 95% CI 0.766-0.857; &lt;i&gt;P&lt;/i&gt; &lt; .001) and a 93% crude risk reduction (RR 0.07; 95% CI 0.05-0.09). For maximum daily dose exceedance, the integrated intervention produced an immediate 72% reduction (OR 0.279; 95% CI 0.128-0.609; &lt;i&gt;P&lt;/i&gt; = .001) and near-complete reduction of overdose errors (RR 0.003; 95% CI 0.001-0.008). A pharmacist-led educational and audit-feedback intervention produced an immediate 94.5% reduction in prolonged treatment duration errors (OR 0.055; 95% CI 0.018-0.168; &lt;i&gt;P&lt;/i&gt; &lt; .001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Passive regulatory restrictions alone were insufficient to improve domperidone prescribing safety. An integrated CDSS and clinical pharmacist-led intervention model achieved rapid, clinically meaningful, and durable reductions in major prescribing errors and provides an adaptable, evidence-based framework for medication safety ","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261433442"},"PeriodicalIF":0.7,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Internal Medicine Clinical Pharmacy Specialists at an Academic Medical Center.","authors":"Katarzyna Blair, Melissa Kocek, Tiffany King, Monika Hornung","doi":"10.1177/00185787261419034","DOIUrl":"https://doi.org/10.1177/00185787261419034","url":null,"abstract":"<p><strong>Introduction: </strong>In 2024, the American College of Clinical Pharmacy (ACCP) completed a nationwide survey to describe the practice of internal medicine clinical pharmacy specialists (IMCPS). IMCPS were asked to report clinical interventions, rates of intervention acceptance, and the significance of those interventions. However, this study did not provide any description of cost avoidance (CA) provided through IMCPS interventions. The PHARM-CRIT trial identified that for each critical care pharmacist hired, there was a CA of about $3 to 9 per $1 spent on pharmacist salary. Similarly, the PHARM-EM study found there was a CA of $1 to 10 per $1 spent on an emergency medicine pharmacist. There is limited data on the cost benefits specific to IMCPS. This study aims to identify the impact of IMCPS at an academic medical center, specifically evaluating the CA provided.</p><p><strong>Objectives: </strong>The primary outcome of this study is the mean number of interventions per IMCPS per 8-hour shift and total CA generated.</p><p><strong>Methods: </strong>This prospective observational study included interventions related to adverse drug event prevention, resource utilization, hands-on care, drug information, and protocol implementation completed by IMCPS. Intervention severity was assessed utilizing the Medication Error Index. Intervention CA was estimated using CA described in the study by Hammond et al. The primary outcome of this study is the mean number of interventions per IMCPS per 8-hour shift and total CA generated. Secondary outcomes include the number of interventions completed, type of intervention completed, severity of intervention, time spent per intervention, average CA per intervention and mean CA per IMCPS.</p><p><strong>Results: </strong>Over a 28-day period, eight IM clinical pharmacy specialists completed 1,826 interventions. The average number of interventions completed by a pharmacist was 228 (IQR: 115-270) which equates to 12.26 interventions per 8-hour shift worked. The total CA for 28 days was $785,772.86 which equates to $10,215,047.24 per year. Per intervention completed by a pharmacist, $430.32 of cost was avoided. For every dollar spent on an IM clinical pharmacy specialist's salary, $9.29 was avoided.</p><p><strong>Conclusion: </strong>IMCPS provided significant CA and medication error prevention, specifically in areas of adverse drug event prevention and resource utilization.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261419034"},"PeriodicalIF":0.7,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Impact of a Pharmacist Driven Penicillin Allergy De-labeling Protocol on Rates of Reported Allergy in the Intensive Care Unit\".","authors":"Diksha Verma, Sudhir Gupta","doi":"10.1177/00185787261435514","DOIUrl":"10.1177/00185787261435514","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261435514"},"PeriodicalIF":0.7,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Feasibility Assessment of EldenCare: A Geriatric Clinical Decision Support System Pilot Study.","authors":"Jehath Syed, Sri Harsha Chalasani, Pratibha Pereira, Ajay Sharma, Vikram Patil, Madhan Ramesh, Col Melanahalli Dayananda, Suresh Kumar Polumuri, Nipun Bhaskar Tank, Thirthala Leesha Pallavi, Thandu Deepa, Ganesh Ghule","doi":"10.1177/00185787261426945","DOIUrl":"10.1177/00185787261426945","url":null,"abstract":"<p><strong>Background: </strong>Medication safety is a critical concern in geriatric care, with high rates of polypharmacy and potentially inappropriate medications among older adult patients in India. The EldenCare application was developed as a digital clinical decision support tool to address these challenges through evidence-based screening and collaborative medication management.</p><p><strong>Objective: </strong>To evaluate the reliability and feasibility of the EldenCare system in supporting safe medication practices among older adults.</p><p><strong>Methods: </strong>This prospective observational study was conducted over 10 days with 22 healthcare professionals and 15 simulated patient profiles. Reliability assessment included the validation of automated clinical calculations (creatinine clearance and glomerular filtration rate) and the evaluation of drug-related problem (DRP) detection. Feasibility was measured using the System Usability Scale (SUS), AttrakDiff Mini questionnaire, and Technology Acceptance Model. A companion mobile application was also evaluated by 15 Android users based on 11 key features.</p><p><strong>Results: </strong>The EldenCare system received positive usability ratings (SUS: 72.82 ± 9.83) and high acceptance scores (perceived usefulness: 5.86 ± 0.65; perceived ease of use: 6.02 ± 0.60) from healthcare professionals, with no significant differences between physicians and clinical pharmacists (<i>P</i> > .05). However, significant technical limitations were identified: (1) none of the 25 test cases for clinical calculations fell within the acceptable ±2% error margin; (2) DRP detection showed inadequate accuracy across all categories (53.42% overall, range: 61.64% to 76.02%, all below the predetermined 95% threshold); and (3) the patient mobile application's medication and appointment reminder notifications failed after 3 days.</p><p><strong>Conclusion: </strong>EldenCare shows promising potential through high user acceptance but requires substantial technical refinement before clinical implementation. Future development should focus on algorithm accuracy, medication database mapping, and notification reliability to enhance medication safety in older adults.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261426945"},"PeriodicalIF":0.7,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}