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Development and evaluation of an algorithm to facilitate drug prescription for inpatients with feeding tubes

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

We aimed to develop and evaluate an algorithm to facilitate drug switching between primary and tertiary care for patients with feeding tubes.

Methods

An expert consortium developed an algorithm and applied it manually to 267 preadmission drugs of 46 patients admitted to a surgical ward of a tertiary care university hospital between June 12 and December 2, 2013, and requiring a feeding tube during their inpatient stay.

Results

The new algorithm considered the following principles: Drugs should be ideally listed on the hospital drug formulary (HDF). Additionally, drugs should include the same ingredient instead of a therapeutic equivalent. Preferred dosage forms were appropriate liquids, followed by solid drugs with liquid administration form, and solid drugs that could be crushed and/or suspended. Of all evaluated drugs, 83.5 % could be switched to suitable drugs listed on the HDF and another 6.0 % to drugs available on the German drug market. Additionally, for 4.1 % of the drugs, the integration of individual switching rules allowed the switch from enteric-coated to immediate-release drugs. Consequently, 6.4 % of the drugs could not be automatically switched and required case-to-case decision by a clinical professional (e.g., from sustained-release to immediate-release).

Conclusions

The predefined principles were successfully integrated in the new algorithm. Thus, the algorithm switched more than 90 % of the evaluated preadmission drugs to suitable drugs for inpatients with feeding tubes. This finding suggests that the algorithm can readily be transferred to an electronic format and integrated into a clinical decision support system.

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Acknowledgments

The authors would like to thank all patients and staff of the surgical ward for participating in the study. This work was partly included in the dissertation of KL.

Conflict of interest

For this study, the authors declare that they have no conflict of interests.

Author information

Authors and Affiliations

  1. Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Kristina Lohmann, Julia Freigofas, Julian Leichsenring, Chantal Marie Wallenwein, Walter Emil Haefeli & Hanna Marita Seidling

  2. Cooperation Unit Clinical Pharmacy, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Kristina Lohmann, Julian Leichsenring, Chantal Marie Wallenwein, Walter Emil Haefeli & Hanna Marita Seidling

Authors
  1. Kristina Lohmann
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  2. Julia Freigofas
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  3. Julian Leichsenring
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  4. Chantal Marie Wallenwein
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  5. Walter Emil Haefeli
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  6. Hanna Marita Seidling
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Corresponding author

Correspondence to Hanna Marita Seidling.

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Lohmann, K., Freigofas, J., Leichsenring, J. et al. Development and evaluation of an algorithm to facilitate drug prescription for inpatients with feeding tubes. Eur J Clin Pharmacol 71, 489–497 (2015). https://doi.org/10.1007/s00228-015-1817-z

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  • DOI: https://doi.org/10.1007/s00228-015-1817-z

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