Pharmacist Mediated Clinical Decision Support Systems: A Narrative Review of Impact and Implementation
Keywords:
Clinical Decision Support System, Clinical Pharmacy, Drug–Drug Interaction, Medication Safety, Pharmacist, Implementation ScienceAbstract
Clinical decision support systems (CDSS) are increasingly deployed to assist pharmacists in managing complex pharmacotherapy, yet their real world effectiveness and implementation determinants remain incompletely characterised. This review synthesises current evidence on pharmacist oriented CDSS for drug–drug interaction mitigation. A narrative review of studies published 2010–2025 was undertaken across PubMed, Scopus and Google Scholar using predefined keywords and Boolean operators. Peer reviewed empirical investigations, systematic reviews and meta analyses examining CDSS impact on medication safety and clinician behaviour were included; titles, abstracts and full texts were independently screened by four reviewers and thematically analysed. Thirty nine eligible studies showed that CDSS increased drug interaction detection rates by up to 40 percent and shortened identification time by a median of 22 percent. Clinician acceptance exceeded 75 percent when alerts were contextualised and interfaces intuitive, although override rates persisted where alert specificity was low. Personalisation based on renal function, QTc interval or comorbidity enhanced relevance and reduced alert burden. Comparative analyses highlighted pronounced adoption gaps between high income and low and middle income countries, driven by infrastructural, policy and training disparities. Interprofessional collaboration and mandatory governance frameworks emerged as critical enablers of sustained utilisation. Evidence confirms that pharmacist integrated CDSS markedly strengthen medication safety processes, but systemic, human factor and policy obstacles temper their full potential. Tailored interface design, workforce upskilling and binding institutional mandates are essential to translate proven efficacy into routine practice and to foster global equity in digital pharmacotherapy.
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