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Cited by 146Electronic Health Records SystemsMedication Adherence and CompliancePharmaceutical Practices and Patient Outcomes

Computerised reminders and feedback in medication management: a systematic review of randomised controlled trials

Bennett, John W, Glasziou, Paul P·2003·Medical Journal of Australia
DOI 10.5694/j.1326-5377.2003.tb05166.x
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Abstract

OBJECTIVE: To systematically review randomised controlled trials (RCTs) of computer-generated medication reminders or feedback directed to healthcare providers or patients. DATA SOURCES: Extensive computerised and manual literature searches identified 76 English-language reports of RCTs reported before 1 January 2002. Searches were conducted between June 1998 and April 2002. STUDY SELECTION: 26 papers making 29 comparisons (two papers reported on multiple interventions) of computer-supported medication management to a control group. DATA EXTRACTION: The quality of the RCTs was systematically assessed and scored independently by two reviewers. Rates of compliance with (potential) reminders for the control and intervention groups were extracted. DATA SYNTHESIS: Heterogeneity of studies prevented a meta-analysis. Where possible, rates were calculated using the intention-to-treat principle. The comparisons were grouped into five areas. Reminders to providers in outpatient settings: six of 12 comparisons demonstrated positive effects (relative rates [RRs: intervention rates/control rates], 1.0 to 42.0). Provider feedback in outpatient settings: five of seven comparisons showed improved clinician behaviour (RRs, 1.0 to 2.5). Combined reminders and feedback in outpatient settings: the single comparison found no improvement. Reminders to providers in inpatient settings: three of five comparisons showed improvements (RRs, 1.0 to 2.1). Patient-directed reminders: two of four comparisons showed improvements in patient compliance. CONCLUSION: Reminders are more effective than feedback in modifying physician behaviour related to medication management. Patient-directed reminders can improve medication adherence.

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  • Reviews covering electronic and paper-based CDSS in multiple clinical areas found they can alter clinician behavior, including screening, test ordering, and adherence to guidelines.

    “Systematic reviews of electronic and paper-based clinical decision support across a range of clinical domains have demonstrated its effectiveness in changing clinicians' practices such as screening, test ordering and guideline adherence, 5 7-9 11-13 but there is no consistent translation into patient outcomes.11”

    From Computerized clinical decision support for prescribing: provision does not guarantee uptake (2010) · cites this paper as [9]

  • Using CDSSs for prescribing can change prescribing to align with guideline recommendations.

    “Systematic reviews have demonstrated that use of CDSSs for prescribing can reduce toxic drug levels and time to therapeutic control, 5 6 reduce medication errors 7 8 and change prescribing in accordance with guideline recommendations.9”

    From Computerized clinical decision support for prescribing: provision does not guarantee uptake (2010) · cites this paper as [9]

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Authors
Bennett, J. W., & Glasziou, P. P.
Affiliations
The University of Queensland (AU)
ORCID
Glasziou, Paul P
Venue
Medical Journal of Australia
Publisher
AMPCo
Published
2003-03
Volume
178
Issue
5
Pages
217-222
ISSN
  • 0025-729X (ISSN-L)
  • 1326-5377
DOI
10.5694/j.1326-5377.2003.tb05166.x
OpenAlex
W1548347845
Cited by
146
References
53
Citations by year
2026: 2 · 2025: 1 · 2023: 1 · 2022: 6 · 2021: 6 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 7 · 2016: 3 · 2015: 6 · 2014: 7 · 2013: 6 · 2012: 13
FWCI
2.34
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Medical Journal of Australia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
provider feedback, medication management, medication adherence, clinician behavior, outpatient settings, inpatient settings
MeSH terms
Drug Therapy, Feedback, Humans, Outpatients, Patient Compliance, Practice Patterns, Physicians', Quality Control, Randomized Controlled Trials as Topic, Reminder Systems

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