Skip to main content
SpringerLink
Log in
Book cover

International Conference on Integrated Formal Methods

IFM 2016: Integrated Formal Methods pp 376–390Cite as

Avoiding Medication Conflicts for Patients with Multimorbidities

  • Conference paper
  • First Online:

Part of the book series: Lecture Notes in Computer Science ((LNPSE,volume 9681))

Abstract

Clinical pathways are care plans which detail essential steps in the care of patients with a specific clinical problem, usually a chronic disease. A pathway includes recommendations of medications prescribed at different stages of the care plan. For patients with three or more chronic diseases (known as multimorbidities) the multiple pathways have to be applied together. One common problem for such patients is the adverse interaction between medications given for different diseases. This paper proposes a solution for avoiding medication conflicts for patients with multimorbidities through the use of formal methods. We introduce the notion of a pharmaceutical graph to capture the medications associated to different stages of a pathway. We then explore the use of an optimising SMT solver (Z3) to quickly find the set of medications with the minimal number and severity of conflicts which is assumed to be the safest. We evaluate the approach on a well known case of an elderly patient with five multimorbidities.

This work is partially supported by EPSRC grant EP/M014290/1.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Notes

  1. 1.

    NICE www.nice.org.uk.

  2. 2.

    http://www.drugs.com.

  3. 3.

    http://www.drugs.com/drug_interactions.html.

References

  1. Abidi, S.R.: Ontology-based knowledge modeling to provide decision support for comorbid diseases. In: Riaño, D., ten Teije, A., Miksch, S., Peleg, M. (eds.) KR4HC 2010. LNCS, vol. 6512, pp. 27–39. Springer, Heidelberg (2011)

    Chapter  Google Scholar 

  2. Abidi, S.R., Abidi, S.S.R.: Towards the merging of multiple clinical protocols and guidelines via ontology-driven modeling. In: Combi, C., Shahar, Y., Abu-Hanna, A. (eds.) AIME 2009. LNCS, vol. 5651, pp. 81–85. Springer, Heidelberg (2009)

    Chapter  Google Scholar 

  3. Barnett, K., Mercer, S., Norbury, M., Watt, G., Wyke, S., Guthrie, B.: Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 380(9836), 37–43 (2012)

    Article  Google Scholar 

  4. Bjørner, N., Phan, A.-D., Fleckenstein, L.: \(\nu \)Z - an optimizing SMT solver. In: Baier, C., Tinelli, C. (eds.) TACAS 2015. LNCS, vol. 9035, pp. 194–199. Springer, Heidelberg (2015)

    Google Scholar 

  5. Boyd, C.M., Darer, J., Boult, C., Fried, L.P., Boult, L., Wu, A.W.: Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA 294(6), 716–724 (2005)

    Article  Google Scholar 

  6. Campbell, H., Hotchkiss, R., Bradshaw, N., Porteous, M.: Integrated care pathways. BMJ 316(7125), 133–137 (1998)

    Article  Google Scholar 

  7. Directorate-General for Health, Food Safety, European Commission: Conference “Which priorities for a European policy on multimorbidity?”, Final report, Brussels, 27 October 2015

    Google Scholar 

  8. Long term conditions compendium of information, 3rd edn., Department of Health (2012)

    Google Scholar 

  9. Hawley, S., Zikmund-Fisher, B., Ubel, P., Jancovic, A., Lucas, T., Fagerlin, A.: The impact of the format of graphical presentation on health-related knowledge and treatment choices. Patient Educ. Couns. 73(3), 448–455 (2008)

    Article  Google Scholar 

  10. Hughes, L.D., McMurdo, M.E.T., Guthrie, B.: Guidelines for people not for diseases: the challenges of applying UK clinical guidelines to people with multimorbidity. Age Ageing 42(1), 62–69 (2013)

    Article  Google Scholar 

  11. Jafarpour, B., Abidi, S.S.R.: Merging disease-specific clinical guidelines to handle comorbidities in a clinical decision support setting. In: Peek, N., Marín Morales, R., Peleg, M. (eds.) AIME 2013. LNCS, vol. 7885, pp. 28–32. Springer, Heidelberg (2013)

    Chapter  Google Scholar 

  12. Kenning, C., Fisher, L., Bee, P., Bower, P., Coventry, P.: Primary care practitioner and patient understanding of the concepts of multimorbidity and self-management: a qualitative study. SAGE Open Med. 1, 1–11 (2013)

    Article  Google Scholar 

  13. López-Vallverdú, J.A., Riaño, D., Collado, A.: Rule-based combination of comorbid treatments for chronic diseases applied to hypertension, diabetes mellitus and heart failure. In: Lenz, R., Miksch, S., Peleg, M., Reichert, M., Riaño, D., ten Teije, A. (eds.) ProHealth 2012 and KR4HC 2012. LNCS, vol. 7738, pp. 30–41. Springer, Heidelberg (2013)

    Chapter  Google Scholar 

  14. de Moura, L., Bjørner, N.S.: Z3: an efficient SMT solver. In: Ramakrishnan, C.R., Rehof, J. (eds.) TACAS 2008. LNCS, vol. 4963, pp. 337–340. Springer, Heidelberg (2008)

    Chapter  Google Scholar 

  15. Mutasingwa, D.R., Ge, H., Upshur, R.E.: How applicable are clinical practice guidelines to elderly patients with comorbidities? Can. Fam. Physician 57(7), e253–e262 (2011)

    Google Scholar 

  16. Negrini, S., Giovannoni, S., Minozzi, S., Barneschi, G., Bonaiuti, D., Bussotti, A., D’Arienzo, M., Lorenzo, N.D., Mannoni, A., Mattioli, S., Modena, V., Padua, L., Serafini, F., Violante, F.: Diagnostic therapeutic flow-charts for low back pain patients: the Italian clinical guidelines. Europa Medicophysica 42(2), 151–70 (2006)

    Google Scholar 

  17. Piovesan, L., Molino, G., Terenziani, P.: An ontological knowledge and multiple abstraction level decision support system in healthcare. Decis. Analytics 1(1), 8 (2014)

    Article  Google Scholar 

  18. Salive, M.E.: Multimorbidity in older adults. Epidemiol. Rev. 35(1), 75–83 (2013)

    Article  Google Scholar 

  19. Shaneyfelt, T., Mayo-Smith, M., Rothwangl, J.: Are guidelines following guidelines? the methodological quality of clinical practice guidelines in the peer-reviewed medical literature. JAMA 281(20), 1900–1905 (1999)

    Article  Google Scholar 

  20. Wilk, S., Michalowski, M., Tan, X., Michalowski, W.: Using first-order logic to represent clinical practice guidelines and to mitigate adverse interactions. In: Miksch, S., Riano, D., Teije, A. (eds.) KR4HC 2014. LNCS, vol. 8903, pp. 45–61. Springer, Heidelberg (2014)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. German Aerospace Center (DLR), Simulation and Software Technology, Braunschweig, Germany

    Andrii Kovalov

  2. School of Computer Science, University of St Andrews, St Andrews, KY16 9SX, Scotland

    Juliana Küster Filipe Bowles

Authors
  1. Andrii Kovalov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juliana Küster Filipe Bowles
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juliana Küster Filipe Bowles .

Editor information

Editors and Affiliations

  1. RWTH Aachen University, Aachen, Germany

    Erika Ábrahám

  2. University of Twente, Enschede, Overijssel, The Netherlands

    Marieke Huisman

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this paper

Cite this paper

Kovalov, A., Bowles, J.K.F. (2016). Avoiding Medication Conflicts for Patients with Multimorbidities. In: Ábrahám, E., Huisman, M. (eds) Integrated Formal Methods. IFM 2016. Lecture Notes in Computer Science(), vol 9681. Springer, Cham. https://doi.org/10.1007/978-3-319-33693-0_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-33693-0_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33692-3

  • Online ISBN: 978-3-319-33693-0

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics

Search

Navigation