Implementation results of automated decision support system for physician’s. Process of anticoagulants prescribing for patients with deep vein thrombosis.

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Background: Timely inpatient antithrombotic therapy describing reduces the risk of recurrent VTE, pulmonary hypertension, fatal outcomes. Physician’s adherence to antithrombotic therapy recommendations in VTE patients reduces the risk of bleeding and the frequency of recurrent thrombosis. Decision support system (DSS) for physician’s can increase adherence to

Aims: DSS development and implementation in hospital to prevention of drug errors and adverse drug events (ADE) associated with anticoagulants using in VTE patients.

Materials and methods: In prospective cohort study we evaluated structure of drug prescriptions and errors, frequency of ADE, cost of drug therapy, physician’s adherence to antithrombotic therapy recommendations in VTE patients before and after introduction of DSS.

Results: There were detected 74 anticoagulant prescribing errors (1.35 per 1 patient) before DSS introduction and 32 anticoagulant prescribing errors adter DSS introduction (0.65 per 1 patient) ) [RS = 2.06; 95-DI: 1.17 -3.63, P = 0.0123]. After DSS introduction, the direct inpatient cost of anticoagulant therapy in VTE patients has reducde from 11 800 (IQR=7000) rubles to 5 430 (IQR=5700) rubles [p<0.005]. The number of ADE did not differ significantly.

Conclusions: DSS can increase physician’s adherence to anticoagualnts dosage  recommendations: prevention of anticoagulants doses unreasonable underestimation / overestimation, unreasonable duration of therapy.                                                                           

Anton Chernov

Russian Medical Academy of Continuing Professional Education

Author for correspondence.
ORCID iD: 0000-0001-6209-387X

Russian Federation

Dmitry A. Sychev

Russian Medical Academy of Continuous Professional Education

ORCID iD: 0000-0002-4496-3680

Russian Federation

MD, PhD, Professor

E. B. Kleymenova

General Medical Center of the Bank of Russia

ORCID iD: 0000-0002-8745-6195

Russian Federation


S. A. Payushchik

General Medical Center of the Bank of Russia

ORCID iD: 0000-0003-1357-0056


L. P. Yashina

General Medical Center of the Bank of Russia

ORCID iD: 0000-0002-7350-0423


Maria D. Nigmatkulova


Vitaly A. Otdelenov


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