title: What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior?
abstract: Alerts and prompts represent promising types of decision support in electronic prescribing to tackle inadequacies in prescribing. A systematic review was conducted to evaluate the efficacy of computerized drug alerts and prompts searching EMBASE, CINHAL, MEDLINE, and PsychINFO up to May 2007. Studies assessing the impact of electronic alerts and prompts on clinicians' prescribing behavior were selected and categorized by decision support type. Most alerts and prompts (23 out of 27) demonstrated benefit in improving prescribing behavior and/or reducing error rates. The impact appeared to vary based on the type of decision support. Some of these alerts (n = 5) reported a positive impact on clinical and health service management outcomes. For many categories of reminders, the number of studies was very small and few data were available from the outpatient setting. None of the studies evaluated features that might make alerts and prompts more effective. Details of an updated search run in Jan 2009 are included in the supplement section of this review.
authors.affiliation: Division of Primary Care, School of Community Health Sciences, Research and Learning Resources Division, Information Services, University of Nottingham, Nottingham, UK. angela.schedlbauer@nottingham.ac.uk
authors.forename: Angela
authors.initials: A
authors.lastname: Schedlbauer
authors.forename: Vibhore
authors.initials: V
authors.lastname: Prasad
authors.forename: Caroline
authors.initials: C
authors.lastname: Mulvaney
authors.forename: Shobha
authors.initials: S
authors.lastname: Phansalkar
authors.forename: Wendy
authors.initials: W
authors.lastname: Stanton
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Avery
mesh_terms: D002983:Clinical Competence; D020000:Decision Support Systems, Clinical; D004360:Drug Therapy, Computer-Assisted; D055695:Electronic Prescribing; D006801:Humans; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000517:prevention & control*; D008509:Medication Systems; D017010:Reminder Systems