Exploring the Utility of Automated Drug Alerts in Home Healthcare
Abstract
Computerized drug utilization review (DUR) can potentially reduce adverse drug events. We examined automated DUR for home healthcare patients with diabetes or hypertension. Sixty-eight percent of diabetes patients and 50.7% of hypertension patients triggered severe, moderate, or duplicative alerts. Among diabetes patients, 74.3% of duplicative alerts were trivial or inappropriate, compared with 3.9% among hypertension patients. Experts judged that 40.5% of high-risk diabetes patients and 53.6% of hypertension patients had alerts requiring nurse follow-up. Adequate follow-up was significantly lower for the former. The relationship between inappropriate alerts and poorer follow-up reinforces the need for more specific alert systems to focus clinicians' attention on clinically important alerts.
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A substantial body of work suggests that repeated CDSS alerts are less likely to be informative.
“This was because a substantial body of work [7, 8, 32, 33] suggests that repeated CDSS alerts are less likely to be informative (that is, they are often equivalent to false alarms).”
From Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system (2017) · cites this paper as [33]
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with the HITEC Investigators, Ancker, J. S., Edwards, A., Nosal, S., Hauser, D., Mauer, E., & Kaushal, R. (2017) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-017-0430-8 · Cited by 709 · see citing works
“We considered alerts that were repeated the same year as potentially uninformative, following the work of previous researchers who have identified repeated alerts as duplicative and likely to have low relevance [7, 8, 32, 33].”
Background
- Authors
- Feldman, P. H., McDonald, M., Rosati, R. J., Murtaugh, C., Kovner, C., Goldberg, J. D., & King, L.
- Affiliations
- VNS Health (US)
- New York University (US)
- ORCID
- Venue
- Journal for Healthcare Quality
- Published
- 2006-01
- Volume
- 28
- Issue
- 1
- Pages
- 29-40
- ISSN
- 1062-2551 (ISSN-L)
- OpenAlex
- W2079060777
- Cited by
- 5
- References
- 24
- Citations by year
- 2017: 1 · 2013: 2
- FWCI
- 0.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal for Healthcare Quality (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (P20 HS11523)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- home health care, diabetes mellitus, hypertension, adverse drug reactions, nurse follow-up, alert prioritization
- MeSH terms
- Aged, Aged, 80 and over, Female, Home Care Services, Humans, Male, Medical Audit, Medication Errors, United States, Adverse Drug Reaction Reporting Systems, Medical Order Entry Systems
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