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Cited by 102Electronic Health Records SystemsPharmaceutical Practices and Patient OutcomesPharmacovigilance and Adverse Drug Reactions

Practitioners’ views on computerized drug-drug interaction alerts in the VA system

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Ko, Y., Abarca, J., Malone, D. C., Dare, D. C., Geraets, D., Houranieh, A., Jones, W. N., Nichol, W. P. +2 more·2007·Journal of the American Medical Informatics Association
DOI 10.1197/jamia.m2224PMC PMC2215077
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Abstract

OBJECTIVES: To assess Veterans Affairs (VA) prescribers' and pharmacists' opinions about computer-generated drug-drug interaction (DDI) alerts and obtain suggestions for improving DDI alerts. DESIGN: A mail survey of 725 prescribers and 142 pharmacists from seven VA medical centers across the United States. MEASUREMENTS: A questionnaire asked respondents about their sources of drug and DDI information, satisfaction with the combined inpatient and outpatient computerized prescriber order entry (CPOE) system, attitude toward DDI alerts, and suggestions for improving DDI alerts. RESULTS: The overall response rate was 40% (prescribers: 36%; pharmacists: 59%). Both prescribers and pharmacists indicated that the CPOE system had a neutral to positive impact on their jobs. DDI alerts were not viewed as a waste of time and the majority (61%) of prescribers felt that DDI alerts had increased their potential to prescribe safely. However, only 30% of prescribers felt DDI alerts provided them with what they needed most of the time. Both prescribers and pharmacists agreed that DDI alerts should be accompanied by management alternatives (73% and 82%, respectively) and more detailed information (65% and 89%, respectively). When asked about suggestions for improving DDI alerts, prescribers most preferred including management options whereas pharmacists most preferred making it more difficult to override lethal interactions. Prescribers and pharmacists reported primarily relying on electronic references for general drug information (62% and 55%, respectively) and DDI information (51% and 79%, respectively). CONCLUSION: Respondents reported neutral to positive views regarding the effect of CPOE on their jobs. Their opinions suggest DDI alerts are useful but still require additional work to increase their clinical utility.

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  • Alert nonadherence, or clinician overrides, occurs for 49%-96% of alerts.

    “Alert nonadherence, or clinician overrides, is one key barrier that occurs for 49%–96% of alerts.13–23”

    From Clinician collaboration to improve clinical decision support: the Clickbusters initiative (2022) · cites this paper as [19]

    In the section labeled “2.6 (1.0) 18” (page unavailable), the paper says that the majority of prescription-order alerts are overridden and do not affect the final prescribing decision. It does not give the claimed 49%–96% range, so it supports frequent overrides but not that numerical estimate. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Cited by

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Authors
Ko, Y., Abarca, J., Malone, D. C., Dare, D. C., Geraets, D., Houranieh, A., Jones, W. N., Nichol, W. P., Schepers, G. P., & Wilhardt, M.
Affiliations
San Francisco VA Medical Center (US)
Corresponding author
Malone, D. C.
ORCID
Venue
Journal of the American Medical Informatics Association
Publisher
Oxford University Press (OUP)
Published
2007-01-01
Volume
14
Issue
1
Pages
56-64
ISSN
  • 1067-5027 (ISSN-L)
  • 1527-974X
DOI
10.1197/jamia.m2224
PMC
PMC2215077
OpenAlex
W2101644441
Cited by
102
References
2
Citations by year
2026: 1 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 1 · 2020: 5 · 2019: 4 · 2017: 2 · 2016: 5 · 2015: 5 · 2014: 11 · 2013: 8 · 2012: 11
FWCI
17.01
Type
journal article
Language
en
Open access
Locations
  • Journal of the American Medical Informatics Association (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Agency for Healthcare Research and Quality (U18 HS010385, U18 HS10385-05)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
Keywords
drug-drug interaction alerts, computerized physician order entry, Veterans Affairs health care, prescriber attitudes, pharmacist attitudes, clinical decision support, drug safety
MeSH terms
Attitude of Health Personnel, Attitude to Computers, Drug Interactions, Drug Therapy, Computer-Assisted, Humans, Medication Errors, Medication Systems, Hospital, Reminder Systems, Medical Order Entry Systems

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