title: Analysis of overridden alerts in a drug-drug interaction detection system.
abstract: OBJECTIVE
  The aim of this study was to evaluate the relevance of the signals generated by a computerized drug-drug interaction detection system and to design a classification of overridden drug-drug interaction alerts.
  
  
  METHODS
  Prospective study over two months.
  
  
  METHODS
  Five hundred and ten-bed university paediatric hospital.
  
  
  METHODS
  In Robert Debré Hospital physicians generate drug orders online using a computerized physician order entry system that also detects drug-drug interactions in real time. We analysed the relevance of a sample of alerts overridden by physicians.
  
  
  RESULTS
  We analysed a sample of 613 overridden alerts. We defined three categories of overridden alerts: informational errors (35); system errors (244) and accurate alerts (334). Two reasons account for 40% of false-positive alerts: an inability of the system to recognize real conflicts between drug treatments and guidelines stating that the two drugs can be used together, because the benefit outweighs the risk of side effects due to the drug-drug interaction.
  
  
  CONCLUSIONS
  We created a classification of overridden alerts, in the context of computerized physician order entry system coupled with a drug-drug interaction detection system. There is clearly room for improvement in the development of drug-drug interaction software. This classification should make it possible to break this work down into smaller tasks, making it possible to decrease the sensitivity to background noise of drug-drug interaction detection systems.
authors.affiliation: AP-HP Hôpital Robert Debré, service pharmacie, 48 boulevard serrurier 75018 Paris. fredericmille@rdb.aphp.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mille
authors.forename: Céline
authors.initials: C
authors.lastname: Schwartz
authors.forename: Francoise
authors.initials: F
authors.lastname: Brion
authors.forename: Jean-Eudes
authors.initials: JE
authors.lastname: Fontan
authors.forename: Olivier
authors.initials: O
authors.lastname: Bourdon
authors.forename: Patrice
authors.initials: P
authors.lastname: Degoulet
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Jaulent
mesh_terms: D004347:Drug Interactions; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control; D008509:Medication Systems; D011446:Prospective Studies; D018570:Risk Assessment