2.4 Clinical Decision Support Alerts
Clinical decision support (CDS) alerts were based on the presence of G6PD deficiency in the problem list or on the absence of a G6PD activity test result coupled with prescribing a high-risk G6PD medication.19-21 A comprehensive list of medications contraindicated in patients with G6PD deficiency lacks universal consensus and remains controversial. This led to the development of an institution-specific two-tiered list of high-risk medications to avoid or to use with caution in patients with G6PD deficiency. This list was originally approved by our institution’s Pharmacogenetics Oversight Committee, Antimicrobial Utilization and Improvement Committee, and Pharmacy and Therapeutics Committee in 2014 and continues to be updated based on evidence in the literature. Medications likely to cause hemolytic anemia were categorized to avoid in G6PD deficiency, whereas medications that may cause hemolytic anemia were categorized to use with caution in patients with G6PD deficiency. The complete list of medications that constituted the avoid and caution lists are detailed in Supplemental Figs. S1A and S1B and can be viewed at www.stjude.org/g6pd.