View source for Are We Heeding the Warning Signs? Examining Providers’ Overrides of Computerized Drug-Drug Interaction Alerts in Primary Care

This article studies the downstream effects of CPOE alerts and how critical it really gets.   <ref name="cDDs7"> Slight SP, Seger DL, Nanji KC, et al. Are We Heeding the Warning Signs? Examining Providers’ Overrides of Computerized Drug-Drug Interaction Alerts in Primary Care. Berthold HK, ed. PLoS ONE. 2013;8(12):e85071. doi:10.1371/journal.pone.0085071. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3873469/ </ref>

== Background ==

This study talks about how too many [[CDS]] alerts can cause clinicians to ignore them and override critical ones. It evaluates the appropriateness of providers’ overrides and the reason why they chose to do so. 

== Methods ==

A total of 24,849 [http://www.bemedwise.org/quiz_facts/facts.htm/ DDI] alerts were generated in the study period, with 40% accepted. The top 62 providers with the highest override rate were identified and eight overrides randomly selected for each (a total of 496 alert overrides for 438 patients, 3.3% of the sample).

== Results ==

After the initial screening, 68.2% (338/496) of the [http://www.bemedwise.org/quiz_facts/facts.htm/ DDI] alert overrides were considered appropriate. A detailed review of the medical charts revealed that the desired action was only carried out in 63.3% (214/338) of these cases. One hundred and thirteen different drugs, and 119 different drug-drug interactions, were found to have triggered the 496 [http://www.bemedwise.org/quiz_facts/facts.htm/ DDI] alerts.About 43.9% prescribers chosen coded reason for the overriding the DDI alerts was ‘will monitor as recommended’ followed by ‘will adjust dose as recommended’(16.9%),‘other' with a free-text provision(16.1%), ‘patient has already tolerated combination’(15.7%).

== Conclusion ==

It was found that even though the alerts were modified to be better accepted by the clinicians, a lot of the them still choose to override these alerts.  

== Comments == 

There really is a fine line between helpful alerts and over-alerting.  Over alerting can cause alert fatigue and lead to users ignoring critical alerts that could potentially prevent patient harm.  There are still a lot of considerations regarding this issue and hoping that it would improve in the future. 

== References ==
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[[Category: Reviews]]
[[Category:CDS]]