Medications: MediSpan Clinical Decision Support & Interactions Service

When it comes to prescribing medication, accuracy is everything. A single missed interaction or overlooked warning can lead to serious consequences for patients, from adverse reactions to ineffective treatments. By carefully checking for interactions during the prescribing process, clinicians can significantly reduce the risk of prescribing errors, ensuring each patient receives the safest and most effective care possible.

This article explores how the MediSpan Clinical Decision Support & Interactions Service uses patient information such as age, allergies, medical history, and even social factors, to automatically detect potential risks and trigger appropriate alerts. Understanding these interaction triggers helps prescribers make informed decisions, minimise medication errors, and enhance patient safety at every step of the prescribing journey.

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Contents:

1. Triggers for Interactions
2. Interaction Types
3. Age
4. Alcohol
5. Allergy
6. Drug Name & Strength
7. Duplicate Drug Name
8. Duplicate Generic Ingredients
9. Food Interaction
10. Gender
11. Medical History Condition
12. Pregnant
13. Related Reading

Triggers for Interactions

Multiple pieces of information from the patient's clinical record are referenced when prescribing medications, and then used to generate different types of warnings and alerts. The following information is used for this purpose:

1. Gender
2. Date of Birth
3. Whether Elite Athlete is ticked within the patient's Social Settings
4. Weight (as recorded in Observations)
5. Whether Breast Feeding is ticked within the patient's Social Settings
6. Whether the patient is marked as pregnant within Obstetrics: Current Pregnancy Records
7. The drug that is currently being prescribed
8. Drugs the patient has been prescribed in the past
9. Recorded Allergies
10. Recorded Conditions in Medical History

Interaction Types

Age

Triggers:

• Patient Age in Patient Details
• Drug-specific alert

Interaction Description: 

Varies, but the message will warn of potential risk of prescribing the medication based on the patient's age. The colour of the alert determines the criticality of the warning.

Alcohol

Triggers:

• Drug-specific alert 

• Does not relate to the patient's Drinking Status in Patient Social

Interaction Description: 

This message will display when the drug has been specifically noted to interact negatively when a patient ingests alcohol while taking this medication. 

Allergy

Triggers:

• Patient has a matching recorded allergy

• Prescription being created contains the drug recorded as an allergy

Interaction Description: 

Warning to the user that this drug will incur an allergic reaction for the patient, as it is or contains an ingredient recorded in the patient’s Allergies & Reactions list.

Drug Name & Strength

Triggers:

• Medication being prescribed is within the same pharmacological drug class as one already contained within the patient's Current RX list

Interaction Description: 

Varies based on the medication. Can generate alerts such as "may enhance the anticoagulation affect", or "[Drug Name 1] increases inactivation of [Drug Name 2] in the stomach and may result in decreased antimicrobial effectiveness" or other similar alerts.

Duplicate Drug Name

Triggers:

• Patient has Medication in Current RX in the same pharmacological Drug Class as the new drug being Prescribed

Interaction Description: 

Warns the user that the drugs are closely related, and may be a duplication of medication already prescribed.

Duplicate Generic Ingredients

Triggers:

• Patient has Medication in Current RX that matches the new drug being Prescribed

Interaction Description: 

Warns the user that the generic ingredients used in this drug are also contained in a drug that is listed as a current medication for the patient.

Food Interaction

Triggers:

• Drug-specific alert 

Interaction Description: 

This message shows as a warning when prescribing certain drugs, for the provider to advise the patient to avoid certain foods while taking the medicine

OR

Provider should advise patient to take or not to take this item with food, as it may change the effectiveness of the medication.

Gender

Triggers:

• Drug-specific when gender is female

• Drug-specific when gender is male

Interaction Description: 

Displays alerts when the drug being prescribed may be impacted by the patient's Gender. For example, "Administration of [Drug Name] is not recommended in Females" or "Administration of [Drug Name] should be used with extreme caution in Child-Bearing Aged Females".

Medical History Condition

Triggers:

• Drug-specific alert
• Condition-specific alert based on patient's Medical History listed Conditions

Interaction Description: 

Warning delivered based on a Condition recorded in the Medical History for the patient, and the drug being prescribed.

Pregnant

Triggers:

• Drug-specific alert
• Patient is marked as Pregnant

Interaction Description: 

Uses colouration to denote the severity of the risk involved in prescribing that specific drug to a pregnant patient, and displays alerts such as "[Drug Name] is not recommended in Pregnancy". 

Related Reading

• Real-Time Prescription Monitoring (RTPM): Configuration & Quick Guide
• Writing Prescriptions: Quick Guide
• Medications: Current & Past RX, and Managing Prescriptions
• Prescribing Schedule 8 (S8) Monitored Medications
• Authority & Streamlined Prescriptions, & State-Based Authorised Reference Numbers