Differences of Reasons for Alert Overrides on Contraindicated Co-prescriptions by Admitting Department.
10.4258/hir.2014.20.4.280
- Author:
Eun Kyoung AHN
1
;
Soo Yeon CHO
;
Dahye SHIN
;
Chul JANG
;
Rae Woong PARK
Author Information
1. Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea. veritas@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Contraindications;
Drug Interactions;
Clinical Decision Support Systems;
Hospital Admitting Department
- MeSH:
Admitting Department, Hospital*;
Adult;
Antirheumatic Agents;
Decision Support Systems, Clinical;
Drug Interactions;
Electronic Health Records;
Emergency Service, Hospital;
Humans;
Observational Study;
Patients' Rooms;
Prescriptions;
Retrospective Studies
- From:Healthcare Informatics Research
2014;20(4):280-287
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVES: To reveal differences in drug-drug interaction (DDI) alerts and the reasons for alert overrides between admitting departments. METHODS: A retrospective observational study was performed using longitudinal Electronic Health Record (EHR) data and information from an alert and logging system. Adult patients hospitalized in the emergency department (ED) and general ward (GW) during a 46-month period were included. For qualitative analyses, we manually reviewed all reasons for alert overrides, which were recorded as free text in the EHRs. RESULTS: Among 14,780,519 prescriptions, 51,864 had alerts for DDIs (0.35%; 1.32% in the ED and 0.23% in the GW). The alert override rate was higher in the ED (94.0%) than in the GW (57.0%) (p < 0.001). In an analysis of the study population, including ED and GW patients, 'clinically irrelevant alert' (52.0%) was the most common reason for override, followed by 'benefit assessed to be greater than the risk' (31.1%) and 'others' (17.3%). The frequency of alert overrides was highest for anti-inflammatory and anti-rheumatic drugs (89%). In a sub-analysis of the population, 'clinically irrelevant alert' was the most common reason for alert overrides in the ED (69.3%), and 'benefit assessed to be greater than the risk' was the most common reason in the GW (61.4%). CONCLUSIONS: We confirmed that the DDI alerts and the reasons for alert overrides differed by admitting department. Different strategies may be efficient for each admitting department.
