# Enabling Shared Decision Making to Reduce Harm from Drug Interactions: An End-to-End Demonstration

> **NIH AHRQ U18** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2020 · $495,869

## Abstract

PROJECT SUMMARY/ABSTRACT
 Drug-drug interactions (DDIs) are preventable adverse events that are responsible for 5–14% of adverse
drug reactions (ADRs) in hospitalized patients and frequently occur in up to 13% of elderly ambulatory patients.
Exposure to life-threatening DDIs continues to occur despite the widespread availability of clinical decision
support systems (CDS). Due to Meaningful Use requirements, most electronic health record (EHR) vendors
have implemented DDI CDS functionality using the underlying logic provided by drug knowledge-base vendors.
A persistent issue is that DDI alerts are overridden at rates as high as 90%. While patients can play a critical
role in preventing potentially catastrophic harm due to DDIs, here are very few tools that help them engage in
shared decision making about DDI risks.
 Recently, studies of interactive decision dashboards have shown the potential to foster informed decision
making by patients. These decision aids allow patients and clinicians to deliberate together about the
advantages and disadvantages of different therapies and arrive at decisions that are concordant with both
clinicians' knowledge and patients' preferences. Accordingly, the overarching goal of this study is to advance
the DDI CDS frontier beyond physician-centered decision making to patient-centered shared decision
making. Our central hypothesis is that interoperable shared decision tools will enhance patient-provider
decision making regarding the risks and benefits of interacting medications.
 The proposed project will use emerging CDS standards (CQL, CDS Hooks, and SMART on FHIR) and a
learning health community (CDS Connect) to enable: (i) novel shared decision-making dashboards that
graphically communicate risks and decision options related to potential DDIs and (ii) broad interoperability for
highly actionable DDI CDS artifacts. Patients and providers will be able to jointly determine the most
appropriate actions to mitigate potential harm. We will accomplish our objectives by pursuing the following
specific aims: Aim 1: Design and evaluate a user-centered CDS dashboard for shared decision making of drug
prescribing concerning risk of DDI harm; Aim 2: Enable contextual DDI CDS rules using CDS Connect; and
Aim 3) Conduct a pilot dissemination of the DDI authoring process, the knowledge artifacts, interoperability,
and the shared decision-making dashboard. This project will markedly improve CDS for DDIs by simplifying the
authoring process and demonstrating interoperable shared patient-physician DDI decision making. We expect
patients will value this critical information as part of their care plan and that providers will benefit from risk
information that is provided real-time without relying on memory recall. Our novel approach, involving partners
across multiple organizations and environments including experts in drug interactions, biomedical informatics,
healthcare information technology standards, and shared-decision making w...

## Key facts

- **NIH application ID:** 10023271
- **Project number:** 5U18HS027099-02
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** DANIEL C MALONE
- **Activity code:** U18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $495,869
- **Award type:** 5
- **Project period:** 2019-09-30 → 2021-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10023271

## Citation

> US National Institutes of Health, RePORTER application 10023271, Enabling Shared Decision Making to Reduce Harm from Drug Interactions: An End-to-End Demonstration (5U18HS027099-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10023271. Licensed CC0.

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