A mixed method study of the merits of e-prescribing drug alerts in primary care
Department of Quantitative Health Sciences
Medical Subject Headings
*Attitude to Computers; *Clinical Pharmacy Information Systems; Data Collection; *Drug Therapy, Computer-Assisted; Female; Focus Groups; Humans; Male; Medical Order Entry Systems; Medication Errors; Nurse Practitioners; Physician Assistants; Physicians, Family; Polypharmacy; Primary Health Care; *Reminder Systems; United States
Bioinformatics | Biostatistics | Epidemiology | Health Services Research
OBJECTIVES: The objective of this paper was to describe primary care prescribers' perspectives on electronic prescribing drug alerts at the point of prescribing.
DESIGN: We used a mixed-method study which included clinician surveys (web-based and paper) and focus groups with prescribers and staff.
PARTICIPANTS: Prescribers (n = 157) working in one of 64 practices using 1 of 6 e-prescribing technologies in 6 US states completed the quantitative survey and 276 prescribers and staff participated in focus groups.
MEASUREMENTS: The study measures self-reported frequency of overriding of drug alerts; open-ended responses to: "What do you think of the drug alerts your software generates for you?"
RESULTS: More than 40% of prescribers indicated they override drug-drug interactions most of the time or always (range by e-prescribing system, 25% to 50%). Participants indicated that the software and the interaction alerts were beneficial to patient safety and valued seeing drug-drug interactions for medications prescribed by others. However, they noted that alerts are too sensitive and often unnecessary. Participant suggestions included: (1) run drug alerts on an active medication list and (2) allow prescribers to set the threshold for severity of alerts.
CONCLUSIONS: Primary care prescribers recognize the patient safety value of drug prescribing alerts embedded within electronic prescribing software. Improvements to increase specificity and reduce alert overload are needed.
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Citation: J Gen Intern Med. 2008 Apr;23(4):442-6. Link to article on publisher's site
Lapane, Kate L.; Waring, Molly E.; Schneider, Karen L.; Dube, Catherine; and Quilliam, Brian J., "A mixed method study of the merits of e-prescribing drug alerts in primary care" (2008). Quantitative Health Sciences Publications and Presentations. 376.