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.