Literature DB >> 17068346

Practitioners' views on computerized drug-drug interaction alerts in the VA system.

Yu Ko1, Jacob Abarca, Daniel C Malone, Donna C Dare, Doug Geraets, Antoun Houranieh, William N Jones, W Paul Nichol, Gregory P Schepers, Michelle Wilhardt.   

Abstract

OBJECTIVES: To assess Veterans Affairs (VA) prescribers' and pharmacists' opinions about computer-generated drug-drug interaction (DDI) alerts and obtain suggestions for improving DDI alerts.
DESIGN: A mail survey of 725 prescribers and 142 pharmacists from seven VA medical centers across the United States. MEASUREMENTS: A questionnaire asked respondents about their sources of drug and DDI information, satisfaction with the combined inpatient and outpatient computerized prescriber order entry (CPOE) system, attitude toward DDI alerts, and suggestions for improving DDI alerts.
RESULTS: The overall response rate was 40% (prescribers: 36%; pharmacists: 59%). Both prescribers and pharmacists indicated that the CPOE system had a neutral to positive impact on their jobs. DDI alerts were not viewed as a waste of time and the majority (61%) of prescribers felt that DDI alerts had increased their potential to prescribe safely. However, only 30% of prescribers felt DDI alerts provided them with what they needed most of the time. Both prescribers and pharmacists agreed that DDI alerts should be accompanied by management alternatives (73% and 82%, respectively) and more detailed information (65% and 89%, respectively). When asked about suggestions for improving DDI alerts, prescribers most preferred including management options whereas pharmacists most preferred making it more difficult to override lethal interactions. Prescribers and pharmacists reported primarily relying on electronic references for general drug information (62% and 55%, respectively) and DDI information (51% and 79%, respectively).
CONCLUSION: Respondents reported neutral to positive views regarding the effect of CPOE on their jobs. Their opinions suggest DDI alerts are useful but still require additional work to increase their clinical utility.

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Year:  2006        PMID: 17068346      PMCID: PMC2215077          DOI: 10.1197/jamia.M2224

Source DB:  PubMed          Journal:  J Am Med Inform Assoc        ISSN: 1067-5027            Impact factor:   4.497


  38 in total

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2.  A cross-site qualitative study of physician order entry.

Authors:  Joan S Ash; Paul N Gorman; Mary Lavelle; Thomas H Payne; Thomas A Massaro; Gerri L Frantz; Jason A Lyman
Journal:  J Am Med Inform Assoc       Date:  2003 Mar-Apr       Impact factor: 4.497

3.  Drug-related deaths in a university central hospital.

Authors:  L Juntti-Patinen; P J Neuvonen
Journal:  Eur J Clin Pharmacol       Date:  2002-09-03       Impact factor: 2.953

4.  GPs' views on computerized drug interaction alerts: questionnaire survey.

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Journal:  J Clin Pharm Ther       Date:  2002-10       Impact factor: 2.512

5.  The medical office of the 21st century (MOXXI): effectiveness of computerized decision-making support in reducing inappropriate prescribing in primary care.

Authors:  Robyn Tamblyn; Allen Huang; Robert Perreault; André Jacques; Denis Roy; James Hanley; Peter McLeod; Réjean Laprise
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6.  Drug-drug interactions among elderly patients hospitalized for drug toxicity.

Authors:  David N Juurlink; Muhammad Mamdani; Alexander Kopp; Andreas Laupacis; Donald A Redelmeier
Journal:  JAMA       Date:  2003-04-02       Impact factor: 56.272

Review 7.  Electronic prescribing in ambulatory practice: promises, pitfalls, and potential solutions.

Authors:  D Papshev; A M Peterson
Journal:  Am J Manag Care       Date:  2001-07       Impact factor: 2.229

8.  Physician satisfaction with two order entry systems.

Authors:  H J Murff; J Kannry
Journal:  J Am Med Inform Assoc       Date:  2001 Sep-Oct       Impact factor: 4.497

9.  Improving recognition of drug interactions: benefits and barriers to using automated drug alerts.

Authors:  Peter A Glassman; Barbara Simon; Pamela Belperio; Andrew Lanto
Journal:  Med Care       Date:  2002-12       Impact factor: 2.983

Review 10.  Drug-related visits to the emergency department: how big is the problem?

Authors:  Payal Patel; Peter J Zed
Journal:  Pharmacotherapy       Date:  2002-07       Impact factor: 4.705

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  33 in total

1.  Impact of the drug-drug interaction database SFINX on prevalence of potentially serious drug-drug interactions in primary health care.

Authors:  M L Andersson; Y Böttiger; J D Lindh; B Wettermark; B Eiermann
Journal:  Eur J Clin Pharmacol       Date:  2012-07-01       Impact factor: 2.953

2.  Evaluation of three brands of drug interaction software for use in intensive care units.

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Journal:  Pharm World Sci       Date:  2010-10-21

3.  Ability of pharmacy clinical decision-support software to alert users about clinically important drug-drug interactions.

Authors:  Kim R Saverno; Lisa E Hines; Terri L Warholak; Amy J Grizzle; Lauren Babits; Courtney Clark; Ann M Taylor; Daniel C Malone
Journal:  J Am Med Inform Assoc       Date:  2010-12-03       Impact factor: 4.497

4.  Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts.

Authors:  Robert B McDaniel; Jonathan D Burlison; Donald K Baker; Murad Hasan; Jennifer Robertson; Christine Hartford; Scott C Howard; Andras Sablauer; James M Hoffman
Journal:  J Am Med Inform Assoc       Date:  2015-10-24       Impact factor: 4.497

5.  Medical alert management: a real-time adaptive decision support tool to reduce alert fatigue.

Authors:  Eva K Lee; Tsung-Lin Wu; Tal Senior; James Jose
Journal:  AMIA Annu Symp Proc       Date:  2014-11-14

6.  CPOE: sufficient, but not perfect, evidence for taking action.

Authors:  Patricia Flatley Brennan
Journal:  J Am Med Inform Assoc       Date:  2007 Jan-Feb       Impact factor: 4.497

Review 7.  Electronic medical records as a tool in clinical pharmacology: opportunities and challenges.

Authors:  D M Roden; H Xu; J C Denny; R A Wilke
Journal:  Clin Pharmacol Ther       Date:  2012-06       Impact factor: 6.875

8.  Assessment of the consistency among three drug compendia in listing and ranking of drug-drug interactions.

Authors:  Božana S Nikolić; Maja S Ilić
Journal:  Bosn J Basic Med Sci       Date:  2013-11       Impact factor: 3.363

9.  A human factors investigation of medication alerts: barriers to prescriber decision-making and clinical workflow.

Authors:  Alissa L Russ; Alan J Zillich; M Sue McManus; Bradley N Doebbeling; Jason J Saleem
Journal:  AMIA Annu Symp Proc       Date:  2009-11-14

Review 10.  Computerized clinical decision support for prescribing: provision does not guarantee uptake.

Authors:  Annette Moxey; Jane Robertson; David Newby; Isla Hains; Margaret Williamson; Sallie-Anne Pearson
Journal:  J Am Med Inform Assoc       Date:  2010 Jan-Feb       Impact factor: 4.497

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