title: Clinical relevance of automated drug alerts from the perspective of medical providers.
abstract: The authors used a real-time survey instrument and subsequent focus group among primary care clinicians at a large healthcare system to assess usefulness of automated drug alerts. Of 108 alerts encountered, 0.9% (n = 1) represented critical alerts, and 16% (n = 17) were significant drug interaction alerts. Sixty-one percent (n = 66) involved duplication of a medication or medication class. The rest (n = 24) involved topical medications, inhalers, or vaccines. Of the 84 potentially relevant alerts, providers classified 11% (9/84), or about 1 in 9, as useful. Drug interaction alerts were more often deemed useful than drug duplication alerts (44.4% versus 1.5%, P < .001). Focus group participants generally echoed these results when ranking the relevance of 15 selected alerts, although there was wide variance in ratings for individual alerts. Hence, a "smarter" system that utilizes a set of mandatory alerts while allowing providers to tailor use of other automated warnings may improve clinical relevance of drug alert systems.
authors.affiliation: VA Greater Los Angeles Healthcare System-West Los Angeles, CA, USA. jeffrey.spina@med.va.gov
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Spina
authors.forename: Peter A
authors.initials: PA
authors.lastname: Glassman
authors.forename: Pamela
authors.initials: P
authors.lastname: Belperio
authors.forename: Rumi
authors.initials: R
authors.lastname: Cader
authors.forename: Steven
authors.initials: S
authors.lastname: Asch
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D001291:Attitude of Health Personnel; D016303:Clinical Pharmacy Information Systems; D003625:Data Collection; D020000:Decision Support Systems, Clinical; D004347:Drug Interactions; D017144:Focus Groups; D006801:Humans; D015141:Los Angeles; D016347:Medical Records Systems, Computerized; D008508:Medication Errors / Q000517:prevention & control*; D010607:Pharmacy Service, Hospital; D011320:Primary Health Care / Q000379:methods*