J Korean Soc Med Inform.
2008 Dec;14(4):373-385.
Development of Renal Dosing System at a University Hospital
- Affiliations
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- 1Department of Pharmacy, Seoul National University Bundang Hospital, Korea.
- 2Center for Interoperable Electronic Health Record, Korea, Korea.
- 3Graduate School of Clinical Pharmacy, Sookmyung Womens's University, Korea.
- 4Department of Internal Medicine, Seoul National University Bundang Hospital, Korea.
- 5Department of Health Policy and Management, College of Medicine, Seoul National University, Korea.
- 6Institute of Health Policy and Management, Seoul National University Medical Research Center, Korea, Korea.
- 7College of Pharmacy, Ewha womans University, Korea. bklee@ewha.ac.kr
Abstract
OBJECTIVE
This report is describing the development and implementation process of the knowledge-based renal dose adjustment system at a university hospital. METHOD: From the hospital drug formulary which included about 1500 medications, clinical pharmacists selected 243 nephrotoxic medications which require dose adjustment in patients with renal impairment. Through literature review and consultation of clinical pharmacists, nephrologist, and infectious disease specialist, we developed an accordant renal dosing knowledge-base and used them to build the rules for dosage adjustment alerts and to provide information related to alerts such as patients' age, gender, most recent weight, latest serum creatinine, calculated creatinine clearance, and recommended dosage for renal insufficiency. STATUS REPORT: As of August 2006, the renal dosing system which monitored drug prescription and generated real-time alerting window to help physician to adjust drug doses in patients with renal impairment was implemented and has been operated well since initial implementation.
CONCLUSION
Renal dosing system based upon knowledge-based renal dosing guideline was successfully developed and implemented into a local clinical practicesetting.
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