Greet Van De Sijpe, Lien Cosemans, Jens Neefs, Hannah De Schutter, Tine Van Nieuwenhuyse, Mariëlle Beckers, Johan Maertens, Hélène Schoemans, Peter Vandenberghe, Minne Casteels, Veerle Foulon, Isabel Spriet
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Health information technology can facilitate the detection of inappropriate prescriptions and assist healthcare professionals in enhancing patient safety.</p><p><strong>Aim: </strong>To evaluate the impact of a pharmacist-oriented clinical decision support system, called Bedside Check of Medication Appropriateness (BED-CMA), on inappropriate prescribing at the hematology ward, and to qualitatively assess its impact on the organization of bedside clinical pharmacy practice.</p><p><strong>Method: </strong>A mixed-methods study was conducted at the semi-critical 15-bed hematology ward of UZ Leuven between 2020 and 2023. A pre-post study was performed to evaluate the impact of BED-CMA on residual potentially inappropriate prescriptions (PIPs), defined as those that persisted for at least 24 h after their initial identification. A time trend analysis was performed to identify any potential pre-existing patterns. The BED-CMA intervention consisted of embedding 19 clinical rules into the hospital information system. The pre-intervention cohort received usual clinical pharmacy services. Post-intervention, clinical pharmacists used BED-CMA alerts in addition to standard practices. A focus group discussion with clinical pharmacists assessed the impact on the organization of bedside clinical pharmacy practice.</p><p><strong>Results: </strong>Pre-intervention, 70% (48/69) of initial PIPs remained residual PIPs, which decreased to 20% (13/66) post-intervention (odds ratio 0.11 (95% confidence interval 0.05-0.22, P < .0.0001)). There was no evidence for a pre-existing time trend (P = .0.52). Pharmacists reported improved workflow efficiency through enhanced patient prioritization and prompt identification of PIPs.</p><p><strong>Conclusion: </strong>BED-CMA significantly reduced residual PIPs by streamlining clinical pharmacy practice at a hematology ward.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of the bedside check of medication appropriateness (BED-CMA) at the hematology ward: a mixed-methods study.\",\"authors\":\"Greet Van De Sijpe, Lien Cosemans, Jens Neefs, Hannah De Schutter, Tine Van Nieuwenhuyse, Mariëlle Beckers, Johan Maertens, Hélène Schoemans, Peter Vandenberghe, Minne Casteels, Veerle Foulon, Isabel Spriet\",\"doi\":\"10.1007/s11096-025-01926-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hematology patients have complex medication regimens and rapidly changing organ function, rendering them susceptible to medication errors. Health information technology can facilitate the detection of inappropriate prescriptions and assist healthcare professionals in enhancing patient safety.</p><p><strong>Aim: </strong>To evaluate the impact of a pharmacist-oriented clinical decision support system, called Bedside Check of Medication Appropriateness (BED-CMA), on inappropriate prescribing at the hematology ward, and to qualitatively assess its impact on the organization of bedside clinical pharmacy practice.</p><p><strong>Method: </strong>A mixed-methods study was conducted at the semi-critical 15-bed hematology ward of UZ Leuven between 2020 and 2023. A pre-post study was performed to evaluate the impact of BED-CMA on residual potentially inappropriate prescriptions (PIPs), defined as those that persisted for at least 24 h after their initial identification. A time trend analysis was performed to identify any potential pre-existing patterns. The BED-CMA intervention consisted of embedding 19 clinical rules into the hospital information system. The pre-intervention cohort received usual clinical pharmacy services. Post-intervention, clinical pharmacists used BED-CMA alerts in addition to standard practices. A focus group discussion with clinical pharmacists assessed the impact on the organization of bedside clinical pharmacy practice.</p><p><strong>Results: </strong>Pre-intervention, 70% (48/69) of initial PIPs remained residual PIPs, which decreased to 20% (13/66) post-intervention (odds ratio 0.11 (95% confidence interval 0.05-0.22, P < .0.0001)). There was no evidence for a pre-existing time trend (P = .0.52). 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The impact of the bedside check of medication appropriateness (BED-CMA) at the hematology ward: a mixed-methods study.
Background: Hematology patients have complex medication regimens and rapidly changing organ function, rendering them susceptible to medication errors. Health information technology can facilitate the detection of inappropriate prescriptions and assist healthcare professionals in enhancing patient safety.
Aim: To evaluate the impact of a pharmacist-oriented clinical decision support system, called Bedside Check of Medication Appropriateness (BED-CMA), on inappropriate prescribing at the hematology ward, and to qualitatively assess its impact on the organization of bedside clinical pharmacy practice.
Method: A mixed-methods study was conducted at the semi-critical 15-bed hematology ward of UZ Leuven between 2020 and 2023. A pre-post study was performed to evaluate the impact of BED-CMA on residual potentially inappropriate prescriptions (PIPs), defined as those that persisted for at least 24 h after their initial identification. A time trend analysis was performed to identify any potential pre-existing patterns. The BED-CMA intervention consisted of embedding 19 clinical rules into the hospital information system. The pre-intervention cohort received usual clinical pharmacy services. Post-intervention, clinical pharmacists used BED-CMA alerts in addition to standard practices. A focus group discussion with clinical pharmacists assessed the impact on the organization of bedside clinical pharmacy practice.
Results: Pre-intervention, 70% (48/69) of initial PIPs remained residual PIPs, which decreased to 20% (13/66) post-intervention (odds ratio 0.11 (95% confidence interval 0.05-0.22, P < .0.0001)). There was no evidence for a pre-existing time trend (P = .0.52). Pharmacists reported improved workflow efficiency through enhanced patient prioritization and prompt identification of PIPs.
Conclusion: BED-CMA significantly reduced residual PIPs by streamlining clinical pharmacy practice at a hematology ward.
期刊介绍：
The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences.
IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy.
IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor.
International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy .
Until 2010 the journal was called Pharmacy World & Science.
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