Effectiveness of an Integrated Clinical Decision Support System and Clinical Pharmacist-Led Interventions in Domperidone Prescribing: A 10-Year Interrupted Time Series Study.
| Title: | Effectiveness of an Integrated Clinical Decision Support System and Clinical Pharmacist-Led Interventions in Domperidone Prescribing: A 10-Year Interrupted Time Series Study. |
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| Authors: | Phuong NTT; Hai Phong University of Medicine and Pharmacy, Vietnam.; Hai Phong International Hospital, Vietnam.; Duong DT; Hai Phong University of Medicine and Pharmacy, Vietnam.; Anh TV; Hai Phong University of Medicine and Pharmacy, Vietnam.; Hai Phong International Hospital, Vietnam.; Long ND; Hai Phong International Hospital, Vietnam.; Anh LD; Hai Phong International Hospital, Vietnam.; Dung HV; Hai Phong International Hospital, Vietnam.; Ngan TT; Hai Phong University of Medicine and Pharmacy, Vietnam.; Hai Phong International Hospital, Vietnam. |
| Source: | Hospital pharmacy [Hosp Pharm] 2026 Apr 12, pp. 00185787261433442. Date of Electronic Publication: 2026 Apr 12. |
| Publication Model: | Ahead of Print |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Sage Publications Country of Publication: United States NLM ID: 0043175 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0018-5787 (Print) Linking ISSN: 00185787 NLM ISO Abbreviation: Hosp Pharm |
| Imprint Name(s): | Publication: : Thousand Oaks, CA : Sage Publications; Original Publication: [Philadelphia] : Lippincott |
| Abstract: | Background: Domperidone is widely prescribed for gastrointestinal motility disorders and nausea-vomiting but is associated with serious cardiac adverse events, leading to regulatory restrictions on its indications, dosage, and duration. However, passive regulatory notifications alone often fail to translate into safer real-world prescribing practices.; Objectives: To evaluate the long-term real-world effectiveness of an integrated prescribing clinical decision support system (CDSS) combined with clinical pharmacist-led interventions in improving the safety and appropriateness of domperidone prescribing.; Methods: A 10-year interrupted time series (ITS) study was conducted including all 51 437 inpatient and outpatient domperidone prescriptions issued between June 2015 and December 2025 at a large tertiary hospital in Vietnam. Sequential interventions were implemented: real-time CDSS alerts for contraindicated drug-drug interactions and daily maximum dose exceedance combined with pharmacist-led audit-feedback targeting dose errors (April 2021), updating the interaction database and pharmacist-led audit-feedback interventions targeting drug-drug interactions (January 2022), and pharmacist-led educational and audit-feedback interventions targeting treatment duration (September 2023). Monthly prescribing error rates were analyzed using segmented quasi-binomial regression with Newey-West robust standard errors.; Results: Prior to intervention, prescribing errors exhibited significant increasing baseline trends for contraindicated drug-drug interactions and maximum daily dose exceedance, whereas prolonged treatment duration errors showed a gradual but significant decreasing trend (P |
| Competing Interests: | The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Contributed Indexing: | Keywords: clinical decision support system; clinical pharmacist intervention; domperidone; interrupted time series; medication safety |
| Entry Date(s): | Date Created: 20260416 Latest Revision: 20260416 |
| Update Code: | 20260416 |
| PubMed Central ID: | PMC13076465 |
| DOI: | 10.1177/00185787261433442 |
| PMID: | 41988210 |
| Database: | MEDLINE |
Journal Article