Clinical decision support for polypharmacy
Precision prescriptions,
personalised medicine.
Drug-PIN scores a patient’s complete medication plan against their laboratory values, genetics, diagnoses, age and habits, and shows every conflict behind the number. The method is patented in Europe, EP 3942570.
220
60 / 200
Illustrative figures, for a plan of 11 medications.
The problem
Prescribing a cocktail is inherently complex.
A medication plan is not a set of independent decisions. Each drug has to be weighed against every other drug, and against the patient’s organ function, genotype, diagnoses and age, then weighed again on every change.
These are the kinds of interaction a complete review has to cover. Drug-PIN evaluates each of them for every plan.
Drug ↔ Drug
Pairwise interactions across the whole plan, weighted by severity, from a rule base of roughly 522,000 entries.
Drug ↔ Gene
Mismatches between the patient’s pharmacogenomic variants and their drugs: CYP enzymes, transporters and targets.
Drug ↔ Disease
Conflicts with the patient’s diagnoses, from some 967,000 rules keyed on 2,908 ICD-10 codes.
Drug ↔ Kidney
Contraindication and caution at the patient’s filtration rate, by stage of renal impairment.
Drug ↔ Liver
Accumulation risk where hepatic clearance is impaired, via the Q₀ fraction for each substance.
Drug ↔ Age
Potentially inappropriate medication in older patients, using PRISCUS from age 65 and the European EU(7)-PIM list.
Drug ↔ Laboratory
QT prolongation against age- and sex-specific thresholds, and free-drug levels where albumin is low.
Drug ↔ Enzyme
The cumulative load the regimen places on each CYP enzyme and transporter, a burden no single pair shows.
The reference data behind these checks is continuously updated.
How it works
Four steps.
From a medication plan to a document you can put in the patient record.
Enter patient data
Medication plan, laboratory values, diagnoses, age and habits, plus genetics where a result exists.
Receive the analysis
A score for the whole plan, with every conflict that produced it listed underneath.
Adjust the therapy
Swap a drug for a comparable one and watch the score move before committing to it.
Issue the report
A final PDF for the patient record. Preview it in full, then commit it.
The score
One number you can act on.
Four sub-scores make up the total, and every point traces back to a conflict you can open.
What makes up this score
- Interactions
- 147
- Metabolism & genetics
- 38
- PRISCUS
- 20
- Kidney
- 15
The four sub-scores sum to the total score, here 220, which is rescaled against patients on the same number of medications to give the normalised score shown above. Every point is traceable: each sub-score opens into the conflicts that produced it.
The conflicts behind it
- Example: illustrative patient
- High
Clarithromycin × simvastatinMyopathy risk
- Medium
CYP2D6 poor metaboliser × tramadolReduced efficacy
- Priscus
Amitriptyline at age 78Alternative suggested
- Kidney
Metformin at eGFR 38 mL/min/1.73 m²Flagged on renal function
For any medication in the plan, Drug-PIN shows a list of alternatives and what each one would do to the score: the whole therapy rescored for that patient.
Drug-PIN supports clinical judgement. It does not replace it, and it does not prescribe.
Institutions
Where Drug-PIN is used.
- Sant’AndreaUniversity Hospital, Rome
- SapienzaUniversità di Roma
- BelcolleViterbo
- IDI-IRCCSIstituto Dermopatico dell’Immacolata, Rome
See it on your own patients.
See Drug-PIN on your own cases. We will set up a trial for your organisation.
Request trial access