377 Detectability of medication errors in older people prior to potentially preventable admissions - SI SUPPLEMENTARY INFORMATION SI1 Detailed description of the STRIP Assistant 2.0 The STRIP Assistant (STRIPA) version 2.0 is a stand-alone, web-based clinical decision support system (CDSS) with integrated STOPP/START version 2 algorithms [1,2]. STRIPA was used to assist the structured medication review according to the Systematic Tool to Reduce Inappropriate Prescribing (STRIP) method within the OPERAM trial [3–5]. Actual medical information at index hospitalisation - from the patient’s electronic health record (EHR) and from the individual patient interview according to the Structured History of Medication taking method (SHiM)-method [6] - were entered into STRIPA by the pharmacotherapy team. This information included diagnoses, current drug use, recent measurements (e.g. blood pressure), laboratory values (e.g. renal function) and suspected adverse drug reactions (i.e. ‘complaints’). Pharmacotherapy optimisation signals, including those based on STOPP/START v2, were generated by STRIPA and evaluated for appropriateness on the individual patient level by the trained physician-pharmacist pair. Table SI1.1 provides a detailed overview the medical information entered in STRIPA, their sources and the databases used alerts. Figure SI1.1 shows an example of STRIPA’s interface for generating a STOPP signal for potential overuse. A detailed description of the OPERAM intervention has been published previously [3]. Table SI1.1. Components of the clinical decision-support tool STRIPA v2.0 used for pharmacotherapy analysis in OPERAM intervention patients. Component Source Database Data entry Diagnoses EHR WHO ICD-10 v2016 [7] Drugs SHiM and EHR WHO ATC codes v2016 [8] Measurements and laboratory values EHR LOINC [9] Potential adverse drug reactions SHiM and EHR MedDRA v2013 [10] Pharmaceutical analysis Check for indications of current drugs Evidence Based Clinical guidelines + Expert opinion* N/A If no clinical indication was found, the drug was linked to dummy code ‘unknown and unspecified causes of morbidity’ which generated STOPP A1 (‘Any drug prescribed without an evidence-based clinical indication’) 4
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