Table 3 Distribution of alerts between risk categories
Risk category1 Risk sub-category2 High-risk situations3 | Number of alerts | Intervention PPV \(\frac{number \;of\; interventions}{{number\; of\; alerts}}\) | Clinical PPV with a pharmacist \(\frac{number\; of \;accepted\; therapeutic\; suggestions }{{number \;of \;interventions}}\) | Clinical PPV without a pharmacist \(\frac{number\; of\; accepted\; therapeutic\; suggestions }{{number \;of \;alerts}}\) |
|---|---|---|---|---|
Drug prescription with an abnormal lab value1 | 242 (54.1%) | 26.9% (n = 65) | 66.2% (n = 43) | 17.8% |
Drug prescription in the presence of renal failure2 | 121 (27.1%) | 33.9% (n = 41) | 70.7% (n = 29) | 24.0% |
DOAC and acute renal failure3 | 64 | 39.1% (n = 25) | 64.0% (n = 16) | 25.0% |
Colchicine and acute renal failure3 | 21 | 28.6% (n = 6) | 66.7% (n = 4) | 19.0% |
Metformin and acute renal failure3 | 20 | 45.0% (n = 9) | 88.9% (n = 8) | 40.0% |
Morphine and acute renal failure3 | 16 | 6.3% (n = 1) | 100% (n = 1) | 6.3% |
Drug prescription combined with a supra-therapeutic serum level2 | 42 (9.4%) | 26.2% (n = 11) | 36.4% (n = 4) | 9.5% |
VKA and supra-therapeutic INR3 | 36 | 19.4% (n = 7) | 28.6% (n = 2) | 5.5% |
Vancomycin and supra-therapeutic vancomycin rate3 | 4 | 75.0% (n = 3) | 33.3% (n = 1) | 25.0% |
Digoxin and supra-therapeutic digoxin rate3 | 1 | 100.0% (n = 1) | 100% (n = 1) | 100.0% |
Aminoglycosides and supra-therapeutic aminoglycoside rate3 | 1 | 0.0% (n = 0) | NA | NA |
Drug prescription combined with an abnormal lab value2 | 79 (17.7%) | 16.5% (n = 13) | 77.0% (n = 10) | 12.7% |
Blood glucose lowering drug and hypoglycemia3 | 30 | 0.0% (n = 0) | NA | NA |
Heparin and thrombopenia3 | 30 | 13.3% (n = 4) | 50.0% (n = 2) | 6.7% |
Digoxin and dyskalemia3 | 15 | 46.7% (n = 7) | 85.7% (n = 6) | 40.0% |
Metformin and acute hyperlactatemia3 | 4 | 50.0% (n = 2) | 100% (n = 2) | 50.0% |
Medication contraindicated or to be used with caution1 | 127 (28.4%) | 3.1% (n = 4) | 75.0% (n = 3) | 2.4% |
Anticholinergic drugs and some comorbidities (e.g., dementia, urinary retention, constipation)3 | 66 | 1.5% (n = 1) | 100% (n = 1) | 1.5% |
Drugs lowering seizure threshold and epilepsy or history of seizure3 | 51 | 2.0% (n = 1) | 0% (n = 0) | 0.0% |
NSAID and some comorbidities (e.g., renal failure, heart failure)3 | 10 | 20.0% (n = 2) | 100% (n = 2) | 20.0% |
Drug–drug interaction1 | 71 (15.9%) | 28.2% (n = 20) | 85.0% (n = 17) | 24.0% |
Co-prescription of 2 anticoagulants3 | 38 | 52.6% (n = 20) | 85.0% (n = 17) | 48.0% |
Co-prescription of 2 serotoninergic drugs3 | 33 | 0.0% (n = 0) | NA | NA |
Inadequate mode of administration1 | 7 (1.6%) | 14.3% (n = 1) | 0.0% (n = 0) | 0.0% |
Methotrexate scheduled twice in fewer than 7 days3 | 5 | 0.0% (n = 0) | NA | NA |
Intravenous potassium chloride at a flow rate > 10 mmol/hour3 | 2 | 50.0% (n = 1) | 0.0% (n = 0) | 0% |
Intravenous potassium chloride at a concentration > 40 mmol/L (peripheral catheter) or >80 mmol/L (central catheter)80 mmol/L (central catheter)3 | 0 | NA | NA | NA |
Total | 447 | 20.1% (n = 90) | 71.0% (n = 63) | 14.0% |