Development of Computerized Decision Support Program on Prescribing High Risk CNS Drugs for Aging Outpatients in Hospitals

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Chanuttha Ploylearmsang
Kannikar Teinkanitikul
Chanchira Choppradit
Surasak Soonthorn
Keeratapan Patisonthi


The proportion of Thai aging population has dramatically increased. With chronic diseases, most elderly had polypharmacy especially central nervous system (CNS) drugs. The adverse drug events might possibly happen. This quasi-experimental study aimed to develop and evaluate a computerized warning program on HOSxP that alerts when prescribing high-risk CNS drugs for elderly. This tool supports physicians and pharmacists to dispense drugs for aging patients with rational and appropriate use. The effect of the computerized warning program was evaluated from the reduction of 9 selected drug items of high-risk CNS drugs for elderly. Data of 3-month before and 2-month after the program implementation in 3 community hospitals were collected. The results showed that 1,432 elderly aged 71.7±7.84 years, female 63.1%, had been prescribed high-risk CNS drugs. After 2-month computerized warning program implementation, total CNS drugs have been prescribed with significant reduction (average 50.2±60.17 and 43.6±61.22 tablets/prescription, p<0.001, respectively). Five items of CNS drugs; including diazepam 2 mg and 5 mg, lorazepam 0.5 mg, amitriptyline 10 and 25 mg, had been decreasingly prescribed. 8 physicians and 5 pharmacists reflected that the computerized warning program is useful, easy to use and accessible. It did not promote only the rational drug use in at the national policy level abut also promoted the computerized program use for supporting quality health care in at the organization level.


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