What strategies do pharmacists use to identify and prevent adverse drug reactions?

In what is believed to be the first study of its kind, researchers examined the cognitive processes health care professionals use to detect, resolve, and monitor adverse drug reactions.

The paper, published in the BMJ, points to the complexity of resolving problems regarding adverse drug reactions and also provides readers with implications to develop novel clinical decision support systems that more closely align with a health care provider’s cognitive workflow.

The researchers reviewed incidents reported at a single VA Medical Center with a focus on both inpatient and outpatient care. Within two to four weeks of select incidents, follow-up critical decision method interviews were conducted with 10 physicians and 10 pharmacists. Researchers then performed quantitative data analysis to identify key decision points and themes. They subsequently developed a descriptive model of how health care providers identify problems and make decisions related to adverse drug reactions.

The model incorporates 4 phases, including problem detection (e.g., through symptoms or information transfer from another health care provider). The other 3 stages include investigation of the root of the problem, risk/benefit considerations, and plan of action and follow-up.

The study authors believe the findings can help train future pharmacists and physicians about adverse drug event decision-making.

In addition, their results may inform the design of clinical decision support systems, which they recommend be fine-tuned to facilitate patient-provider communication in order to better detect and address adverse drug reactions, among other changes.