Cover Page
The handle http://hdl.handle.net/1887/25551 holds various files of this Leiden University
dissertation.
Author: Rommers, Mirjam Kristien
Title: Clinical rules in hospital pharmacy practice to prevent adverse drug events
Issue Date: 2014-05-06
Clinical rules in hospital
pharmacy practice to prevent
adverse drug events
Mirjam Rommers
The research presented in this thesis was performed at the Department of Clinical Pharmacy
and Toxicology of Leiden University Medical Center, Leiden, The Netherlands, except for
the research in chapter 5.
The research presented in this thesis was financially supported by the Dutch Society of
Hospital Pharmacists (NVZA), the Dutch Society of Hospital Physicians (OMS) and the
Dutch Ministry of Health, Welfare and Sports.
The studies presented in chapter 6 and chapter 7 of this thesis were part of a larger study
program, entitled ‘Implementation of interventions for preventing adverse drug events in
high risk patient populations in primary care and care institutions, by a team of doctors and
hospital pharmacists’. This study program was financially supported by the Patient Safety
Program of the Netherlands Organisation for Health research and Development (ZonMw)
(filenumber 8140.0001).
Financial support for the publication of this thesis was provided by AZL Onderzoeks- en
Ontwikkelingskrediet (OOK) Apotheek.
Cover design Esther Ris, Proefschriftomslag.nl
Layout Renate Siebes, Proefschrift.nu
Printed by Ipskamp Drukkers B.V.
ISBN 978-90-9028194-0
© 2014 M.K. Rommers
All rights reserved. No part of this publication may be reproduced or transmitted in any
form or by any means, electronic or mechanical, including photocopy, recording, or any
information storage or retrieval system, without permission in writing from the author.
Clinical rules in hospital
pharmacy practice to prevent
adverse drug events
Proefschrift
ter verkrijging van
de graad van Doctor aan de Universiteit Leiden,
op gezag van Rector Magnificus prof.mr. C.J.J.M. Stolker,
volgens besluit van het College voor Promoties
te verdedigen op dinsdag 6 mei 2014
klokke 13.45 uur
door
Mirjam Kristien Rommers
geboren te Eindhoven
in 1974
Promotiecommissie
Promotor Prof.dr. H-J. Guchelaar
Copromotor
Dr. I.M. Teepe-Twiss
Overige leden
Prof.dr. J. Kievit
Prof.dr. J.G.W. Kosterink
Rijksuniversiteit Groningen
Prof.dr. L. Lie-a-Huen
Universiteit Amsterdam
Dr. P.H.E.M. de Meijer
Voor Mees & Saar
Contents
Part I: Introduction
Chapter 1
General introduction
11
Chapter 2
Preventing adverse drug events in hospital practice: an overview
19
Part II: Analytical validity
Chapter 3
Development of a computerized alert system, ADEAS, to identify
patients at risk for an adverse drug event
35
Part III: Clinical validity
Chapter 4
A computerized adverse drug event alerting system using
clinical rules: A retrospective and prospective comparison with
conventional medication surveillance in The Netherlands
57
Chapter 5
Comparison of methods for identifying patients at risk of
medication related harm
75
Part IV: Clinical utility
Chapter 6
Preventing adverse drug events in the elderly patient with
polypharmacy by use of clinical rules and interventions by
hospital pharmacists
Chapter 7
Evaluation of rule effectiveness and prospective predictive value
of clinical rules in a Dutch clinical decision support system in daily
hospital pharmacy practice
91
107
Part V: Discussion and summary
Chapter 8
General discussion
129
Summary
149
Samenvatting
157
Dankwoord
165
Curriculum vitae
169
List of publications
173