Use of computerized provider order entry in two ambulatory settings failed to lower rate of preventable adverse drug events.J Patient Saf. 2015 May 21; [Epub ahead of print].
Ambulatory computerized prescribing and preventable adverse drug events.
Overhage JM, Gandhi TK, Hope C, et al. J Patient Saf. 2015 May 21; [Epub ahead of print].
Computerized provider order entry (CPOE) systems have been shown to prevent prescribing errors, though their effect on clinical adverse drug events (ADEs) remains controversial. A limitation of the existing evidence in this area is that most studies have been in the hospital setting. This study of electronic prescribing in primary care clinics in Boston and Indianapolis found results similar to hospital-based studies, in that the overall rate of preventable ADEs was unchanged after CPOE implementation. In many cases, physicians' failure to heed decision support warnings—possibly due to alert fatigue—may have contributed to ADEs. An interesting, although unexplained, finding in this study was that the baseline ADE rate was more than seven times higher at the Indianapolis sites compared to the Boston sites. A case of a hospital admission due to an outpatient adverse drug event is discussed in a previous AHRQ WebM&M commentary.
Reducing warfarin medication interactions: an interrupted time series evaluation.
Feldstein AC, Smith DH, Perrin N, et al. Arch Intern Med. 2006;166:1009-1015.
Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial.
Schnipper JL, Gandhi TK, Wald JS, et al. J Am Med Inform Assoc. 2012;19:728-734.
Characteristics associated with postdischarge medication errors.
Mixon AS, Myers AP, Leak CL, et al. Mayo Clin Proc. 2014;89:1042-1051.
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Predicting potential postdischarge adverse drug events and 30-day unplanned hospital readmissions from medication regimen complexity.
Schoonover H, Corbett CF, Weeks DL, Willson MN, Setter SM. J Patient Saf. 2014;10:186-191.