Provider and pharmacist responses to warfarin drug-drug interaction alerts: a study of healthcare downstream of CPOE alerts.

Objective: To categorize the appropriateness of provider and pharmacist responses to warfarin critical drug-drug interaction (cDDI) alerts, assess responses and actions to the cDDI, and determine the occurrence of warfarin adverse drug events (ADE) after alerts.

Design: An 18-month, retrospective study of acute care admissions at a single Veterans Affairs medical center using computerized provider order entry (CPOE).

Measurements: Patients included had at least one warfarin cDDI alert.

Determining vancomycin clearance in an overweight and obese population.

Purpose: Two methods of calculating vancomycin clearance were compared to determine the best body weight measure to use when dosing vancomycin for overweight and obese patients.

Methods: Hospitalized veterans weighing more than 120% of their ideal body weight (IBW) with serum vancomycin concentrations (SVCs) drawn between January 1, 2003, and June 30, 2005, were eligible for study inclusion. Exclusion criteria included weight of more than 300% the IBW, unstable renal function, dialysis, uncertain vancomycin dosing or sampling times, and distribution-phase sampling.

Comparing two predictive methods for determining serum vancomycin concentrations at a Veterans Affairs Medical Center.

Purpose: Two predictive methods for determining serum vancomycin concentrations (SVCs) at a Veterans Affairs medical center were compared.

Methods: The data for inpatients at the San Francisco Veterans Affairs Medical Center who received i.v.

Clinical and economic outcomes of pharmacist recommendations in a Veterans Affairs medical center.

Pharmacist recommendations and their clinical and economic outcomes in a Veterans Affairs (VA) medical center were studied. The first 600 pharmacist recommendations that met study criteria were evaluated for type and frequency, rate of acceptance by physicians, potential benefit or harm, and economic consequences. The study site included inpatient and outpatient settings and a skilled-nursing facility.