TLC-Act: A Novel Tool for Managing Drug Interactions.

Can J Hosp Pharm

, BSc, BSc(Pharm), PharmD, ACPR, FCSHP, is with Vancouver General Hospital, Vancouver Coastal Health, and the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia.

Published: July 2022

AI Article Synopsis

  • - The study focused on enhancing clinical decision support systems (CDSS) by creating a new tool, TLC-Act, to help pharmacists manage drug-drug interactions (DDIs) based on their clinical reasoning rather than relying solely on existing systems.
  • - The research involved developing the tool, implementing it in practice, and gathering feedback from pharmacy residents through an online survey, with validation conducted via simulations prior to implementation.
  • - Results showed that 73% of the pharmacy residents who responded to the survey found TLC-Act to be more useful than traditional CDSS for assessing DDIs, highlighting its alignment with how pharmacists think clinically.

Article Abstract

Background: Clinical decision support systems (CDSS) are used by pharmacists to assist in managing drug-drug interactions (DDIs). However, previous research suggests that such systems may perform suboptimally in providing clinically relevant information in practice.

Objectives: The primary objective of this study was to develop a novel DDI management tool to reflect the clinical thought process that a pharmacist uses when assessing a DDI. The secondary objective was to investigate practitioners' perceptions of this tool.

Methods: This study was conducted in 3 phases: development of the DDI management tool, implementation of the tool in clinical practice, and collection of practitioners' opinions of the tool through an online qualitative survey (although because of circumstances related to the COVID-19 pandemic, the study population for the survey phase included only pharmacy residents). A comprehensive literature search and analysis by an expert panel provided underlying context for the DDI management tool. The tool was validated through simulation against a known list of DDIs before implementation into practice by hospital pharmacists and pharmacy residents. Participating pharmacy residents were invited to provide feedback on the tool. Survey results were analyzed using descriptive statistics.

Results: The novel tool that was developed in this study (called TLC-Act) consisted of components important to a pharmacist when assessing a DDI, including the duration of concomitant use of the interacting medications and patient-specific risk factors. Study participants implemented the tool in clinical practice for a total of 6 weeks. Of the 28 pharmacy residents surveyed, 15 (54%) submitted a response, of whom 11 (73%) found the TLC-Act tool to be slightly more useful for assessing a DDI than usual care with the CDSS alone.

Conclusions: The TLC-Act tool maps out a pharmacist's clinical thought process when assessing a DDI in practice. This novel tool may be more useful than a CDSS alone for managing DDIs, as it takes into account other important factors pertinent to the assessment of a DDI.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245403PMC
http://dx.doi.org/10.4212/cjhp.3171DOI Listing

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