Table 3 Summary of physicians’ approaches using CDSSs on patient follow-up after administration of renally excreted or nephrotoxic drugs

McCoy et al. [34]

A system sent interruption alerts to physicians when contraindicated or highly toxic medications needed to be avoided or adjusted when serum creatinine levels of hospitalized patients increased to 0.5 mg/dL or more within 48 h of prescribing at least one of 122 nephrotoxic or renally excreted drugs

The rate of change or discontinuation per 100 events of medications included in the interruption alert within 24 h of an increase in creatinine levels improved from 35.2% before intervention to 52.6% after intervention (p < 0.001)

Awdishu et al. [25]

A system for outpatients and acutely ill adult patients with kidney impairment monitored changes in kidney function in patients taking one of the targeted renally excreted or nephrotoxic drugs and recommended discontinuation or adjustment of drug dosage when necessary

The rate of appropriate adjustment or drug discontinuation was significantly higher in the intervention group (10.9%) than in the control group (4%) (p < 0.0001)

Pou et al. [37]

A system detected hospitalized patients who had an AKI event while taking nephrotoxic drugs and alerted them to interruptions to determine whether the prescriber subsequently reduced the dose or discontinued the drug

The proportion of patients whose nephrotoxic drugs were changed or discontinued increased to 78 out of 384 nephrotoxicity alerts (20%) in the control group and 154 out of 526 nephrotoxicity alerts (29%) in the intervention group (p < 0.01)