An electronic alert to decrease Kayexalate ordering

Abstract

Important safety concerns have recently emerged regarding the use of sodium polystyrene sulfonate (Kayexalate), a cation-exchange resin commonly used for the treatment of hyperkalemia. We implemented an electronic alert system at a tertiary care academic medical center to warn providers of the safety concerns of Kayexalate. We assessed the number of Kayexalate prescriptions per month, as well as the number of grams of Kayexalate ordered per month, one year before versus one year after implementing the alert. The mean (±SD) number of Kayexalate orders decreased from 123 (±12) to 76 (±14) orders/month (38% absolute reduction, p < 0.001) after implementing the alert. Additionally, the mean (±SD) amount of Kayexalate prescribed decreased from 3332 (±329) to 1885 (±358) g/month (43% absolute reduction, p < 0.001). We conclude that an electronic alert is an effective tool to decrease Kayexalate ordering.

Keywords:

• Electronic alert
• hyperkalemia
• patient safety
• potassium
• quality improvement

Disclosure statement

G.D.S. reports having received a contract from MetaWare to study decision-support software. D.B.M. reports having consulted for ZS Pharma and for Up-to-date.

Funding

D.E.L. is supported by K23DK106448 from the National Institutes of Health-National Institute of Diabetes and Digestive and Kidney Diseases.