+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Variation in high-priority drug-drug interaction alerts across institutions and electronic health records



Variation in high-priority drug-drug interaction alerts across institutions and electronic health records



Journal of the American Medical Informatics Association 24(2): 331-338



The United States Office of the National Coordinator for Health Information Technology sponsored the development of a "high-priority" list of drug-drug interactions (DDIs) to be used for clinical decision support. We assessed current adoption of this list and current alerting practice for these DDIs with regard to alert implementation (presence or absence of an alert) and display (alert appearance as interruptive or passive). We conducted evaluations of electronic health records (EHRs) at a convenience sample of health care organizations across the United States using a standardized testing protocol with simulated orders. Evaluations of 19 systems were conducted at 13 sites using 14 different EHRs. Across systems, 69% of the high-priority DDI pairs produced alerts. Implementation and display of the DDI alerts tested varied between systems, even when the same EHR vendor was used. Across the drug pairs evaluated, implementation and display of DDI alerts differed, ranging from 27% (4/15) to 93% (14/15) implementation. Currently, there is no standard of care covering which DDI alerts to implement or how to display them to providers. Opportunities to improve DDI alerting include using differential displays based on DDI severity, establishing improved lists of clinically significant DDIs, and thoroughly reviewing organizational implementation decisions regarding DDIs. DDI alerting is clinically important but not standardized. There is significant room for improvement and standardization around evidence-based DDIs.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059234515

Download citation: RISBibTeXText

PMID: 27570216

DOI: 10.1093/jamia/ocw114


Related references

Core drug-drug interaction alerts for inclusion in pediatric electronic health records with computerized prescriber order entry. Journal of Patient Safety 10(1): 59-63, 2014

High-priority drug-drug interactions for use in electronic health records. Journal of the American Medical Informatics Association 19(5): 735-743, 2013

Criteria for assessing high-priority drug-drug interactions for clinical decision support in electronic health records. Bmc Medical Informatics and Decision Making 13(1): 65, 2013

High-priority and low-priority drug-drug interactions in different international electronic health record systems: A comparative study. International Journal of Medical Informatics 111: 165-171, 2018

Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record. Journal of General Internal Medicine 33(11): 1868-1876, 2018

Electronic drug interaction alerts in ambulatory care: the value and acceptance of high-value alerts in US medical practices as assessed by an expert clinical panel. Drug Safety 34(7): 587-593, 2011

Wide variation and patterns of physicians' responses to drug-drug interaction alerts. International Journal for Quality in Health Care 31(2): 89-95, 2018

Provider and pharmacist responses to warfarin drug-drug interaction alerts: a study of healthcare downstream of CPOE alerts. Journal of the American Medical Informatics Association 18 Suppl 1: I45-I50, 2012

Adherence to drug-drug interaction alerts in high-risk patients: a trial of context-enhanced alerting. Journal of the American Medical Informatics Association 20(3): 494-498, 2013

Missed drug therapy alerts as a consequence of incomplete electronic patient records in Dutch community pharmacies. Annals of PharmacoTherapy 47(10): 1272-1279, 2014

Successful strategy to improve the specificity of electronic statin-drug interaction alerts. European Journal of Clinical Pharmacology 65(11): 1149-1157, 2009

Drug-Drug Interaction Profiles of Medication Regimens Extracted from a De-Identified Electronic Medical Records System. AMIA Joint Summits on Translational Science Proceedings. AMIA Joint Summits on Translational Science 2016: 33-40, 2016

Literature based drug interaction prediction with clinical assessment using electronic medical records: novel myopathy associated drug interactions. Plos Computational Biology 8(8): E1002614, 2012

Drug-drug interaction between valproic acid and meropenem: a retrospective analysis of electronic medical records from neurosurgery inpatients. Journal of Clinical Pharmacy and Therapeutics 42(2): 221-227, 2017

Using linked data for mining drug-drug interactions in electronic health records. Studies in Health Technology and Informatics 192: 682-686, 2015