Table 5

Selected set of 16 clinical rules

No of safety alerts: that is patients triggered by clinical ruleNo of patients with a corresponding error in medication review (%)
1. Clearance <50 ml/min or serum creatinine >150 μmol/l12923 (18)
2. Serum creatinine increase of >50 μmol/l or of >50%3711 (30)
3. Use of cefuroxime and clearance <50 ml/min70 (0)
4. Use of ceftazidime and clearance of <100 ml/min20 (0)
5. Use of ciprofloxacin and clearance of <25 ml/min112 (18)
6. Use of ranitidine and clearance of <50 ml/min51 (20)
7. Use of cetirizine and clearance of <10 ml/min00 (−)
8. Use of sulfonamides urea derivate and clearance of <10 ml/min00 (−)
9. Gabapentine of pregabaline and clearance of <50 ml/min10 (0)
10. Use of digoxin >0.0625 mg once daily and
  • Age >70 years or

  • Clearance <50 ml/min or

  • Low level of K or

  • Unknown level of K

140 (0)
11. A serum level of an aminoglycoside or vancomycin30 (0)
12. Use of opioid and no prescription for laxative4526 (58)
13. Use of ciprofloxacin or norfloxacin and use of antiepileptic20 (0)
14. Use of bisphosphonate and a drug which has an effect on absorption293 (10)
15. Use of iron and a drug which forms a complex with iron116 (55)
16. Use of azathioprine (check dose)170 (0)
Total31372 (23)