Assessing the strengths and weaknesses of a computer assisted medication review in hospitalized patients

Kim P.g.m. Hurkens*, Carlota Mestres-gonzalvo, Hugo A.j.m. De Wit, Rob Janknegt, Frans Verhey, Jos M.g.a. Schols, Fabienne Magdelijns, Coen D.a. Stehouwer, Bjorn Winkens, Wubbo Mulder, P. Hugo M. Van Der Kuy

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Medication reviews are an essential part of daily routine at a hospital ward but are prone to mistakes. With this study we want to assess the strengths and weaknesses of a Clinical Decision Support System (CDSS) and evaluate the additional value on the reduction of medication errors compared with manual medication reviews.
Materials and Methods
We gathered all remarks related to (potential) errors in the current medication regime (notifications) regarding medication errors for 332 patients from 12 grand rounds of the internal medicine ward and orthopedic ward at the Maastricht University Medical Centre during four months. Simultaneously, we electronically extracted data regarding the patient’s medication list, laboratory data and patient characteristics and entered these data into our CDSS.
Results and Discussion
One hundred thirty-eight notifications were made during grand rounds. One-hundred and seventy-nine relevant alerts were reported by the CDSS. Only three of the relevant notifications were reported by both. Overall, errors regarding indication without medication and medication without indication were most frequently noticed during grand rounds and contraindications or side effects were most frequently noticed by the CDSS. The CDSS may be a relevant addition to the manual performed medication reviews in the hospital. The strength of the present CDSS lies in the detection of errors regarding contraindications and side effects. Future developments include optimizing the cut off values at which the CDSS should provide an alert is an important next step in improving the CDSS. Additionally, in order to increase notifications about indication without medication and medication without indication, the medical history should be incorporated into the CDSS. Finally, relevance on patient outcome should be determined.
Original languageEnglish
Pages (from-to)1-12
Number of pages12
JournalInternational Journal of Hospital Pharmacy
Issue number6
Publication statusPublished - 2017

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