PP065 - DEVELOPMENT OF AN ELECTRONIC HEALTH RECORD-INTEGRATED TOOL TO MONITOR PARENTERAL NUTRITION THERAPY

PP065

DEVELOPMENT OF AN ELECTRONIC HEALTH RECORD-INTEGRATED TOOL TO MONITOR PARENTERAL NUTRITION THERAPY

B. Deleenheer^1,2,3,*, H. Gastmans⁴, K. Cosaert², P. Declercq², S. Hoekx⁵, N. Lauwers¹, N. Moerman², Y. Overloop¹, N. Pauwels¹, S. Pauwels⁶, I. Spriet^2,7, J. Vanderstappen^3,5, R. Vangoitsenhoven^6,8, C. Quintens², T. Vanuytsel^1,3

¹Leuven Intestinal Failure and Transplantation (LIFT), ²Hospital Pharmacy, University Hospitals Leuven, ³Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium, ⁴Hospital Pharmacy, Curaçao Medical Center, Willemstad, Curaçao, ⁵Department of Gastroenterology and Hepatology, ⁶Department of Endocrinology, University Hospitals Leuven, ⁷Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, ⁸Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium

Rationale: Parenteral nutrition (PN) is essential for patients with intestinal failure but costly and associated with complications, making safe and appropriate prescribing crucial. The Check of Medication Appropriateness (CMA) tool was developed to improve PN prescribing quality. This study evaluated its impact on PN prescribing and monitoring.

Methods: The CMA is an electronic health record-integrated tool that uses clinical rules to detect potentially inappropriate prescriptions. Twenty rules, based on guidelines and multidisciplinary consensus, address monitoring (e.g. body weight, NRS-2002, liver tests, glycaemia), prevention of deficiencies (e.g. micronutrients) and complications (e.g. refeeding syndrome, liver dysfunction, fluid overload) and cost reduction (e.g. reviewing PN need). The resulting alerts were reviewed by pharmacists, who added notes to the patient’s file when relevant. Physicians’ acceptance was documented within 2 working days. A retrospective observational study was conducted (Sept 2024-Sept 2025), including all patients receiving PN on a general hospital ward. The proportion of alerts leading to a note and of notes accepted by the physician were assessed. Cutoffs of >70% and >80% defined good and very good acceptance.

Results: Over 13 months, 6565 alerts were automatically generated (mean of 21/day; 3.3 per admission with PN), of which 1584 (24%) resulted in a note. Most recommendations concerned glucose-(314/1584), weight-(235/1584) or NRS-2002 monitoring (232/1584). Overall acceptance was 78% (1027/1313 evaluable recommendations). Fifteen rules showed good acceptance, 11 of which achieved very good acceptance (e.g. prevention of liver dysfunction, refeeding syndrome or micronutrient deficiencies).

Conclusion: The CMA is a promising tool to monitor in-hospital PN therapy, with high acceptance. The role of artificial intelligence will be explored to increase the low recommendation rate. 

Disclosure of Interest: None declared