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Prescriber response to computerized drug alerts for electronic prescriptions among hospitalized patients
- Source :
- International journal of medical informatics. 107
- Publication Year :
- 2016
-
Abstract
- Background Clinical decision support systems (CDSS) reduce prescription errors, but their effectiveness is reduced by high alert rates, “alert fatigue”, and indiscriminate rejection. Objectives To compare acceptance rates of alerts generated by the SafeRx ® prescription CDSS among different alert types and departments in a tertiary care hospital, identify factors associated with alert acceptance, and determine whether alert overrides were justified. Methods In a retrospective study, we compared acceptance rates of all prescription alerts generated in 2013 in 18 departments of Israel’s largest tertiary care center. In a prospective study in 2 internal medicine departments, we collected data on factors potentially associated with alert override, and an expert panel evaluated the justification for each overridden alert. We used multivariate analyses to examine the association between patient and physician-related factors and alert acceptance. Results In the retrospective study, of 390,841 prescriptions, 37.1% triggered at least one alert, 5.3% of which were accepted. Acceptance rates ranged from 7.9% for excessive dose alerts to 4.0% for duplicate drug and major drug-drug interactions alerts (p Conclusions The vast majority of SafeRx ® alerts are overridden, and overriding is justified in most cases. Minimizing the number of alerts is essential to reduce the likelihood of developing “alert fatigue”. Our findings may inform a rational, department-specific approach for alert silencing.
- Subjects :
- Drug
Male
medicine.medical_specialty
Multivariate analysis
020205 medical informatics
Hospitalized patients
media_common.quotation_subject
Health Informatics
02 engineering and technology
Clinical decision support system
Medical Order Entry Systems
03 medical and health sciences
Electronic Prescribing
0302 clinical medicine
Physicians
0202 electrical engineering, electronic engineering, information engineering
medicine
Humans
Medication Errors
Drug Interactions
030212 general & internal medicine
Prospective Studies
Medical prescription
Practice Patterns, Physicians'
Prospective cohort study
Electronic Prescriptions
media_common
Aged
Retrospective Studies
business.industry
Retrospective cohort study
medicine.disease
Decision Support Systems, Clinical
Emergency medicine
Female
Medical emergency
business
Subjects
Details
- ISSN :
- 18728243
- Volume :
- 107
- Database :
- OpenAIRE
- Journal :
- International journal of medical informatics
- Accession number :
- edsair.doi.dedup.....39b304f1ec5bb03b276897bf92400e60