title: Development and validation of a survey instrument for assessing prescribers' perception of computerized drug-drug interaction alerts.
abstract: OBJECTIVE
  To develop a theoretically informed and empirically validated survey instrument for assessing prescribers' perception of computerized drug-drug interaction (DDI) alerts.
  
  
  METHODS
  The survey is grounded in the unified theory of acceptance and use of technology and an adapted accident causation model. Development of the instrument was also informed by a review of the extant literature on prescribers' attitude toward computerized medication safety alerts and common prescriber-provided reasons for overriding. To refine and validate the survey, we conducted a two-stage empirical validation study consisting of a pretest with a panel of domain experts followed by a field test among all eligible prescribers at our institution.
  
  
  RESULTS
  The resulting survey instrument contains 28 questionnaire items assessing six theoretical dimensions: performance expectancy, effort expectancy, social influence, facilitating conditions, perceived fatigue, and perceived use behavior. Satisfactory results were obtained from the field validation; however, a few potential issues were also identified. We analyzed these issues accordingly and the results led to the final survey instrument as well as usage recommendations.
  
  
  CONCLUSIONS
  High override rates of computerized medication safety alerts have been a prevalent problem. They are usually caused by, or manifested in, issues of poor end user acceptance. However, standardized research tools for assessing and understanding end users' perception are currently lacking, which inhibits knowledge accumulation and consequently forgoes improvement opportunities. The survey instrument presented in this paper may help fill this methodological gap.
  
  
  CONCLUSIONS
  We developed and empirically validated a survey instrument that may be useful for future research on DDI alerts and other types of computerized medication safety alerts more generally.
authors.affiliation: Department of Health Management and Policy, School of Public Health, The University of Michigan, Ann Arbor, Michigan 48109-2029, USA. kzheng@umich.edu
authors.forename: Kai
authors.initials: K
authors.lastname: Zheng
authors.forename: Kathleen
authors.initials: K
authors.lastname: Fear
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Chaffee
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Zimmerman
authors.forename: Edward M
authors.initials: EM
authors.lastname: Karls
authors.forename: Justin D
authors.initials: JD
authors.lastname: Gatwood
authors.forename: James G
authors.initials: JG
authors.lastname: Stevenson
authors.forename: Mark D
authors.initials: MD
authors.lastname: Pearlman
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003625:Data Collection; D004347:Drug Interactions; D004360:Drug Therapy, Computer-Assisted; D006801:Humans; D050316:Medical Order Entry Systems; D017010:Reminder Systems; D011795:Surveys and Questionnaires