Deep learning application to automated classification of recommendations made by hospital pharmacists during medication prescription review

Am J Health Syst Pharm. 2024 May 24;81(11):e296-e303. doi: 10.1093/ajhp/zxae011.

Abstract

Purpose: Recommendations to improve therapeutics are proposals made by pharmacists during the prescription review process to address suboptimal use of medicines. Recommendations are generated daily as text documents but are rarely reused beyond their primary use to alert prescribers and caregivers. If recommendation data were easier to summarize, they could be used retrospectively to improve safeguards for better prescribing. The objective of this work was to train a deep learning algorithm for automated recommendation classification to valorize the large amount of recommendation data.

Methods: The study was conducted in a French university hospital, at which recommendation data were collected throughout 2017. Data from the first 6 months of 2017 were labeled by 2 pharmacists who assigned recommendations to 1 of the 29 possible classes of the French Society of Clinical Pharmacy classification. A deep neural network classifier was trained to predict the class of recommendations.

Results: In total, 27,699 labeled recommendations from the first half of 2017 were used to train and evaluate a classifier. The prediction accuracy calculated on a validation dataset was 78.0%. We also predicted classes for unlabeled recommendations collected during the second half of 2017. Of the 4,460 predictions reviewed, 67 required correction. When these additional labeled data were concatenated with the original dataset and the neural network was retrained, accuracy reached 81.0%.

Conclusion: To facilitate analysis of recommendations, we have implemented an automated classification system using deep learning that achieves respectable performance. This tool can help to retrospectively highlight the clinical significance of daily medication reviews performed by hospital clinical pharmacists.

Keywords: classification; clinical pharmacy; deep learning; drug-related problem; medication review.

MeSH terms

  • Deep Learning*
  • Drug Prescriptions / standards
  • France
  • Hospitals, University / standards
  • Humans
  • Pharmacists*
  • Pharmacy Service, Hospital* / organization & administration
  • Pharmacy Service, Hospital* / standards
  • Retrospective Studies