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Docs Override Most Electronic Drug Warnings

Study suggest streamlining of prescribing system to avoid 'alert fatigue'

THURSDAY, Feb. 12 (HealthDay News) -- Doctors often override electronic medication safety alerts and rely instead on their own judgment when prescribing drugs for patients, which suggests that physicians find the alerts more annoying than helpful, says a U.S. study.

Researchers looked at the electronic prescriptions generated by 2,872 doctors at community-based outpatient practices in Massachusetts, New Jersey and Pennsylvania and at the medication alerts associated with those prescriptions. The doctors submitted 3.5 million electronic prescriptions from January through September, 2006, and about one in 15 (6.6 percent) of those prescription orders produced an alert for a drug interaction or drug allergy.

Of those 233,537 alerts, 98.6 percent were for a potential interaction with a drug being taken by a patient.

The researchers found that doctors overrode more than 90 percent of the drug interaction alerts and 77 percent of the drug allergy alerts. The high override rate suggests major improvements are needed to improve the usefulness of electronic medication alerts, they said.

"The sheer volume of alerts generated by electronic prescribing systems stands to limit the safety benefits," the study's first author, Dr. Thomas Isaac, of the Dana-Farber Cancer Institute and Beth Israel Deaconess Medical Center in Boston, said in a Dana-Farber news release. "Too many alerts are generated for unlikely events, which could lead to alert fatigue. Better decision support programs will generate more pertinent alerts, making electronic prescribing more effective and safer."

Isaac and colleagues suggested several ways to improve medication safety alerts, including:

  • Reclassifying the severity of alerts, especially those that are frequently overridden
  • Providing an option for doctors to suppress alerts for medications a patient already has received
  • Customizing the alerts for a physician's specialty

The study was published in the Feb. 9 issue of Archives of Internal Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more about medicine safety.

-- Robert Preidt

SOURCE: Dana-Farber Cancer Institute, news release, Feb. 10, 2009

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