which pmr system

[alexandria]

i am using eclipe pmr should i stick with them or change,have found that
it does not give enough information about drug interactions and
explaining the reasons, starting mur soon

[Pharmanaut]

Cegedim's Pharmacy Manager uses interactions under license from Stockley. The re is a brief message about each interaction and importantly what to do about it. The interactions are 'evidence based' so that a the "class effect" stuff is rationalised to reduce mis-reports. I've been told that cegedim are overhauling the interactions to use improved messages similar to those in the Pocket Stockley. As well as that any queries that cegedim can't answer are escalated to the Stockley team at the Pharmaceutical Press.

Oddly, cegedim have used Stockley for years, since they were jrc so they are so used to having them that the marketing of it is just a sentence in their booklet.

Hope this helps.

[Steve G]

Originally Posted by alexandria

i am using eclipe pmr should i stick with them or change,have found that
it does not give enough information about drug interactions and
explaining the reasons, starting mur soon

The company I work for use Eclipse, and I don't particularly like it. It's unstable (we are grateful we get through a day without having to restart), lots of the warning labels need changing and the endorsing is useless. As for the interactions, I ignore at least half of the ones it flashes up - it warns me about using bendroflumethiazide and ramipril together (increased hypotensive effect), flashes up red (warning, death etc) for combinations of drugs that may prolong QT interval, but nothing for salbutamol and atenolol.

[Pharmanaut]

Originally Posted by Steve G

The company I work for use Eclipse, and I don't particularly like it. It's unstable (we are grateful we get through a day without having to restart), lots of the warning labels need changing and the endorsing is useless. As for the interactions, I ignore at least half of the ones it flashes up - it warns me about using bendroflumethiazide and ramipril together (increased hypotensive effect), flashes up red (warning, death etc) for combinations of drugs that may prolong QT interval, but nothing for salbutamol and atenolol.

Can you put a suppression on the interaction - once you have decided that it is OK?

[Steve G]

Yes, if you decide it's ok you can supress the warning, but it just throws up so much rubbish it's unbelivable. When something interacts with warfarin, it tells you about it for every single strength of warfarin the patient has had. Which is annoying to say the least.

[Pharmanaut]

Originally Posted by Steve G

Yes, if you decide it's ok you can supress the warning, but it just throws up so much rubbish it's unbelivable. When something interacts with warfarin, it tells you about it for every single strength of warfarin the patient has had. Which is annoying to say the least.

Just a few thoughts as this sort of stuff is interesting...
Do you mean it reports every historical instance of Warfarin 1mg, 3mg and 5mg if you dispense an interacting drug (back to the usual 6 months default cut-off?) I think most PMRs would report 1mg, 3mg and 5mg separately, but possibly only for the last instance of dispensing. There may be two things at work here, the quality of the interaction messages and the implementation of the software that picks up the interaction pairs. Not easy to get it right even if the programmer is a pharmacist themselves, then it has to be tested thoroughly before it gets out of the door, a tough job, even if the tester is another pharmacist! A third point - is the commercial pressure to complete that part of the project. Another tough one is drug-doubling - trying to get that not to over-report must be a nightmare, would Warfarin 1mg, 3mg and 5mg be drug doubling? Perhaps not, but two are prescribed generically and one by brand we might want to be alerted?

I'm going to shut up now - must be my longest post to-date.

[NexphaseNorthy]

If it's of interest, Nexphase warns you of an interaction once per family.

Eg: PMR containts Warfarin 1mg and Warfarin 2mg, you dispense Aspirin and you get one warning of the interaction between Aspirin and Warfarin.

[Pharmanaut]

Originally Posted by NexphaseNorthy

If it's of interest, Nexphase warns you of an interaction once per family.

Eg: PMR containts Warfarin 1mg and Warfarin 2mg, you dispense Aspirin and you get one warning of the interaction between Aspirin and Warfarin.

Wonder what it does when you dispense a sulphonylurea, (s) with capozide?
Does it come up with two warnings, ACE Inhibitor may enhance s and thiazide may make s seem less effective? Bit of a risk if someone doesn't read all the warnings?

[NexphaseNorthy]

I'm afraid you'd need to be more specific - not being a pharmacist I'm not sure what drug name I'd need to dispense alongside capozide to test for you. If you would like, let me know an example of a script: Alternatively, you could talk to Cegedim directly and ask to speak to someone in their Professional Services Dept (Chertsey office).

[Pharmanaut]

Originally Posted by NexphaseNorthy

I'm afraid you'd need to be more specific - not being a pharmacist I'm not sure what drug name I'd need to dispense alongside capozide to test for you. If you would like, let me know an example of a script: Alternatively, you could talk to Cegedim directly and ask to speak to someone in their Professional Services Dept (Chertsey office).

How about Capozide Tablets, or Innozide Tablets with Gliclazide 80mg Tablets