Clinicians Ignore Most Drug Alerts From CPOE Systems, Study Finds

Most medication warnings generated by hospitals' computerized provider order entry systems are overridden or ignored by clinicians, according to research presented at the annual meeting of the Society of Hospital Medicine, MedPage Today reports.

Study Details

For the study, researchers examined data from a 410-bed medical center that uses a CPOE system from Meditech. The system uses data on drug interactions to generate warnings if a medication order creates a risk of allergic reactions, adverse events, interactions and duplications.

The analysis looked at 6,646 patients whose medication order triggered a drug alert through the CPOE system.

Key Findings

Researchers found that clinicians accepted only 4% of the 40,391 drug warning alerts issued during the one-year study period.

Of the medication alerts issued:

  • 47% involved potential drug duplications;
  • 47% involved potential drug interactions;
  • 6% involved potential allergic reactions; and
  • 0.1% involved potential adverse reactions.

Amy Knight -- assistant professor of medicine at Johns Hopkins Bayview Medical Center and lead author of the study -- said, "The least common warnings were those that were most frequently accepted, with the average accepted warnings for drug interactions and allergy being 37% and 10%, respectively."

According to Knight, clinicians using CPOE systems often "develop 'alert fatigue' and end up overriding many potentially important warnings." She recommended that CPOE system developers restructure medication alert programs "to more clearly differentiate between types of warnings and, in particular, to distinguish the warnings that are most likely to have severe consequences" (Walsh, MedPage Today, 4/6).

Related Study

Knight's findings coincide with a separate study published last week in the International Journal of Medical Informatics. The IJMI study found that electronic health record-based medication alerts might occur too frequently and contain warnings that are too detailed to help busy health care providers (iHealthBeat, 4/2).

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