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Development of a computerised decisions support system for renal risk drugs targeting primary healthcare.

Helldén A, Al-Aieshy F, Bastholm-Rahmner P, Bergman U, Gustafsson LL, Höök H, Sjöviker S, Söderström A, Odar-Cederlöf I - BMJ Open (2015)

Bottom Line: The GPs found the CDSS fast, simple and easy to use.Acceptance of the simple graphical interface of this push and pull renal CDSS was high among the primary care physicians evaluating this proof of concept.The graphical model should be useful for further development of renal decision support systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.

No MeSH data available.


Related in: MedlinePlus

(A–D An elderly woman's list of medications integrated into the Janus window. When the general practitioner (GP) opens the medication list, the ‘renal button’ appears automatically in the Janus tool bar (A) (push level). Shown are also the buttons for drugs recommended in pregnancy, and in breastfeeding. The owl is a symbol for ‘the wise list’ of basic recommended drugs in Stockholm.3 The degree of renal function is presented in a colour code (white, yellow and red) according to the cut-off points of renal function. The GP must then decide to click the ‘renal button’ (pull level) and is presented with a selection of drugs on the medication list, for which dosing adjustment might be needed. Four drugs are shown: metformin, doxycycline, morphine and oxazepam. For each of these drugs, a short recommendation is given (“If”) automatically after the first click (B). An additional click (“Show more”) is required to visualise each of the following short texts (“Why” or “Because”). The “Because” text also includes two references (1 and 2), but could not be shown in this figure.6566 In case information is missing, clicking the grey colour ‘renal button’ will display an alert, indicating which information is missing (C), or outdated (D) and indicating which drugs might be affected in case the information was available, with need for dose adjustments. GFR=creatinine clearance estimated according to the equation of Cockcroft & Gault, absolute values in mL/min.
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BMJOPEN2014006775F2: (A–D An elderly woman's list of medications integrated into the Janus window. When the general practitioner (GP) opens the medication list, the ‘renal button’ appears automatically in the Janus tool bar (A) (push level). Shown are also the buttons for drugs recommended in pregnancy, and in breastfeeding. The owl is a symbol for ‘the wise list’ of basic recommended drugs in Stockholm.3 The degree of renal function is presented in a colour code (white, yellow and red) according to the cut-off points of renal function. The GP must then decide to click the ‘renal button’ (pull level) and is presented with a selection of drugs on the medication list, for which dosing adjustment might be needed. Four drugs are shown: metformin, doxycycline, morphine and oxazepam. For each of these drugs, a short recommendation is given (“If”) automatically after the first click (B). An additional click (“Show more”) is required to visualise each of the following short texts (“Why” or “Because”). The “Because” text also includes two references (1 and 2), but could not be shown in this figure.6566 In case information is missing, clicking the grey colour ‘renal button’ will display an alert, indicating which information is missing (C), or outdated (D) and indicating which drugs might be affected in case the information was available, with need for dose adjustments. GFR=creatinine clearance estimated according to the equation of Cockcroft & Gault, absolute values in mL/min.

Mentions: The ClCG result was visualised with an image of a kidney in three different colours according to the ClCG value (figure 2A). Advice on how ClCG should be used as support for individualised pharmacotherapy is shown (figure 2B). Each advice for selection and dosage was according to three principles:


Development of a computerised decisions support system for renal risk drugs targeting primary healthcare.

Helldén A, Al-Aieshy F, Bastholm-Rahmner P, Bergman U, Gustafsson LL, Höök H, Sjöviker S, Söderström A, Odar-Cederlöf I - BMJ Open (2015)

(A–D An elderly woman's list of medications integrated into the Janus window. When the general practitioner (GP) opens the medication list, the ‘renal button’ appears automatically in the Janus tool bar (A) (push level). Shown are also the buttons for drugs recommended in pregnancy, and in breastfeeding. The owl is a symbol for ‘the wise list’ of basic recommended drugs in Stockholm.3 The degree of renal function is presented in a colour code (white, yellow and red) according to the cut-off points of renal function. The GP must then decide to click the ‘renal button’ (pull level) and is presented with a selection of drugs on the medication list, for which dosing adjustment might be needed. Four drugs are shown: metformin, doxycycline, morphine and oxazepam. For each of these drugs, a short recommendation is given (“If”) automatically after the first click (B). An additional click (“Show more”) is required to visualise each of the following short texts (“Why” or “Because”). The “Because” text also includes two references (1 and 2), but could not be shown in this figure.6566 In case information is missing, clicking the grey colour ‘renal button’ will display an alert, indicating which information is missing (C), or outdated (D) and indicating which drugs might be affected in case the information was available, with need for dose adjustments. GFR=creatinine clearance estimated according to the equation of Cockcroft & Gault, absolute values in mL/min.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499680&req=5

BMJOPEN2014006775F2: (A–D An elderly woman's list of medications integrated into the Janus window. When the general practitioner (GP) opens the medication list, the ‘renal button’ appears automatically in the Janus tool bar (A) (push level). Shown are also the buttons for drugs recommended in pregnancy, and in breastfeeding. The owl is a symbol for ‘the wise list’ of basic recommended drugs in Stockholm.3 The degree of renal function is presented in a colour code (white, yellow and red) according to the cut-off points of renal function. The GP must then decide to click the ‘renal button’ (pull level) and is presented with a selection of drugs on the medication list, for which dosing adjustment might be needed. Four drugs are shown: metformin, doxycycline, morphine and oxazepam. For each of these drugs, a short recommendation is given (“If”) automatically after the first click (B). An additional click (“Show more”) is required to visualise each of the following short texts (“Why” or “Because”). The “Because” text also includes two references (1 and 2), but could not be shown in this figure.6566 In case information is missing, clicking the grey colour ‘renal button’ will display an alert, indicating which information is missing (C), or outdated (D) and indicating which drugs might be affected in case the information was available, with need for dose adjustments. GFR=creatinine clearance estimated according to the equation of Cockcroft & Gault, absolute values in mL/min.
Mentions: The ClCG result was visualised with an image of a kidney in three different colours according to the ClCG value (figure 2A). Advice on how ClCG should be used as support for individualised pharmacotherapy is shown (figure 2B). Each advice for selection and dosage was according to three principles:

Bottom Line: The GPs found the CDSS fast, simple and easy to use.Acceptance of the simple graphical interface of this push and pull renal CDSS was high among the primary care physicians evaluating this proof of concept.The graphical model should be useful for further development of renal decision support systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.

No MeSH data available.


Related in: MedlinePlus