A systematic approach to optimize electronic health record medication alerts in a health system.
Am J Health Syst Pharm
; 76(8): 530-536, 2019 Apr 08.
Article
em En
| MEDLINE
| ID: mdl-31361861
ABSTRACT
PURPOSE:
The effectiveness of a systematic, streamlined approach to optimize drug-drug interaction alerts in an electronic health record for a health system was studied.METHODS:
An 81-week quasi-experimental study was conducted to evaluate interventions made to medication-related clinical decision-support (CDS) alerts. Medication-related CDS alerts were systematically reduced using a multi disciplinary healthcare committee. The primary endpoint was weekly overall, modification, and acknowledgement rates of medication alerts after drug-drug interaction reclassification. Secondary endpoints included sub analysis of types of medication alerts (drug-drug interaction and duplicate therapy alerts) and alert use by providers (pharmacist and prescribers). Data was analyzed using interrupted time series regression analysis.RESULTS:
After implementation of the new alert system, total number of weekly inpatient alerts decreased from 68,900 (66,300-70,900) and 50,300 (48,600-53,600) in the postintervention period (p < 0.001). The perentage of alerts acknowledged weekly increased from 11.8% (IQR, 11.4-12.1%) in the preintervention period to 13.7% (IQR, 13.3-14.0%) in the postintervention period (p < 0.001). The percentage of alerts that were modified also increased from 5.0% (IQR, 4.9-5.3%) in the preintervention period to 7.3% (IQR, 7.0-7.6%) in the postintervention period (p < 0.001). Both increases were primarily seen with pharmacists versus other healthcare professionals (p < 0.001).CONCLUSION:
A committee-led systematic approach to optimizing drug-drug interactions facilitated a significant decrease in the overall number of alerts and an increase in both medication alert acknowledgement and modification rates.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sistemas de Apoio a Decisões Clínicas
/
Sistemas de Registro de Ordens Médicas
/
Registros Eletrônicos de Saúde
/
Erros de Medicação
Tipo de estudo:
Evaluation_studies
/
Prognostic_studies
/
Sysrev_observational_studies
Aspecto:
Implementation_research
Limite:
Humans
Idioma:
En
Revista:
Am J Health Syst Pharm
Assunto da revista:
FARMACIA
/
HOSPITAIS
Ano de publicação:
2019
Tipo de documento:
Article