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- Title
A mixed method study of the merits of e-prescribing drug alerts in primary care.
- Authors
Lapane, Kate L.; Waring, Molly E.; Schneider, Karen L.; Dubé, Catherine; Quilliam, Brian J.; Dubé, Catherine
- Abstract
<bold>Objectives: </bold>The objective of this paper was to describe primary care prescribers' perspectives on electronic prescribing drug alerts at the point of prescribing.<bold>Design: </bold>We used a mixed-method study which included clinician surveys (web-based and paper) and focus groups with prescribers and staff.<bold>Participants: </bold>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.<bold>Measurements: </bold>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?"<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
UNITED States; MEDICAL care; PRIMARY care; DRUG side effects; DRUG prescribing; MEDICAL research; MEDICAL technology; MEDICAL informatics; CLINICAL trials; MEDICATION error prevention; ATTITUDE (Psychology); DRUG therapy; COMPUTERS; FOCUS groups; PHARMACY databases; COMPUTERS in medicine; NURSE practitioners; GENERAL practitioners; PHYSICIANS' assistants; PRIMARY health care; RESEARCH funding; ACQUISITION of data; HEALTH care reminder systems; POLYPHARMACY
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 4, p442
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-008-0505-4