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Clinicians override most electronic medication safety alerts
Date:2/10/2009

BOSTON--Computer-based systems that allow clinicians to prescribe drugs electronically are designed to automatically warn of potential medication errors, but a new study reveals clinicians often override the alerts and rely instead on their own judgment.

The study, led by investigators at Dana-Farber Cancer Institute and Beth Israel Deaconess Medical Center (BIDMC), suggests that most clinicians find the current medication alerts more of an annoyance than a valuable tool. The authors conclude that if electronic prescribing is to effectively enhance patient safety, significant improvements are necessary. The study's findings appear in the Feb. 9 issue of the Archives of Internal Medicine.

"Electronic prescribing clearly will improve medication safety, but its full benefit will not be realized without the development and integration of high-quality decision support systems to help clinicians better manage medication safety alerts," says the study's senior author Saul Weingart, MD, PhD, vice president for patient safety at Dana-Farber and an internist at BIDMC.

The researchers reviewed the electronic prescriptions and associated medication safety alerts generated by 2,872 clinicians at community-based outpatient practices in Massachusetts, New Jersey, and Pennsylvania to learn how clinicians responded to the alerts.

The clinicians submitted 3.5 million electronic prescriptions between Jan. 1, and Sept. 30, 2006. Approximately one in 15 prescription orders, or 6.6 percent, produced an alert for a drug interaction or a drug allergy. The vast majority of the 233,537 alerts (98.6 percent) were for a potential interaction with a drug a patient already takes.

Clinicians overrode more than 90 percent of the drug interaction alerts and 77 percent of the drug allergy alerts. Even when a drug interaction alert was rated with high severity, clinicians typically dismissed those for medications commonly used in combination
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Contact: Bill Schaller
william_schaller@dfci.harvard.edu
617-632-5357
Dana-Farber Cancer Institute
Source:Eurekalert  

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