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Clinical relevance ...
Clinical relevance of alerts from a decision support system, PHARAO, for drug safety assessment in the older adults
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- Hedna, Khedidja, 1978 (author)
- Linköpings universitet,Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Centrum för åldrande och hälsa (AgeCap),Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry,Centre for Ageing and Health (Agecap),Institutionen för medicin och hälsa,Medicinska fakulteten,Univ Gothenburg, Sweden
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- Andersson, M. L. (author)
- Karolinska Institutet,Karolinska Inst, Sweden
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- Gyllensten, Hanna, 1979 (author)
- Karolinska Institutet,Gothenburg University,Göteborgs universitet,Centrum för personcentrerad vård vid Göteborgs universitet (GPCC),Extern,Institutionen för vårdvetenskap och hälsa,University of Gothenburg Centre for person-centred care (GPCC),External,Institute of Health and Care Sciences,Karolinska Inst, Sweden; Univ Gothenburg, Sweden; Univ Gothenburg, Sweden
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- Hägg, Staffan, 1963- (author)
- Linköpings universitet,Avdelningen för läkemedelsforskning,Medicinska fakulteten,Region Östergötland, Klinisk farmakologi,Futurum, Sweden
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- Böttiger, Ylva (author)
- Linköpings universitet,Avdelningen för läkemedelsforskning,Medicinska fakulteten,Region Östergötland, Klinisk farmakologi
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(creator_code:org_t)
- 2019-06-11
- 2019
- English.
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In: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 19:1, s. 164-
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Abstract
Subject headings
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- BackgroundPHARAO is a decision support system developed to evaluate the risk for a set of either common or serious side-effects resulting from a combination of pharmacodynamic effects from a patient's medications. The objective of this study was to investigate the validity of the risk scores for the common side-effects generated by PHARAO in older patients.MethodsSide-effects included were sedation, constipation, orthostatic symptoms, anticholinergic and serotonergic effects. The alerts generated by PHARAO were tested in 745 persons 65years old. Dispensed prescriptions retrieved from the Swedish prescribed drug register were used to generate the pharmacological risk scores of patients' medications. Symptoms possibly related to side-effects were extracted from medical records data.ResultsThe PHARAO system generated 776 alerts, most often for the risk of anticholinergic symptoms. The total specificity estimates of the PHARAO system were 0.95, 0.89 and 0.78 for high, intermediate and low risk alerts, respectively. The corresponding sensitivity estimates were between 0.12 and 0.37. The negative predictive value was 0.90 and the positive predictive value ranged between 0.20-0.25.ConclusionsThe PHARAO system had a high specificity and negative predictive value to detect symptoms possibly associated with the of patients' medications, while the sensitivity and positive predictive value were low. The PHARAO system has the potential to minimise the risk of over-alerts in combination with a drug-drug interaction alert system, but should be used in connection with a medical evaluation of the patient.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Annan medicin och hälsovetenskap -- Gerontologi, medicinsk/hälsovetenskaplig inriktning (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Other Medical and Health Sciences -- Gerontology, specialising in Medical and Health Sciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmaceutiska vetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmaceutical Sciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Keyword
- Adverse drug reaction
- Clinical decision support system
- Older adults
- Drug interactions
- Validity
- performance
- prevalence
- mortality
- events
- impact
- risk
- Geriatrics & Gerontology
- Adverse drug reaction; Clinical decision support system; Older adults; Drug interactions; Validity
Publication and Content Type
- ref (subject category)
- art (subject category)
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