title: Information technology interventions to improve medication safety in primary care: a systematic review.
abstract: OBJECTIVE
  Improving medication safety has become a major topic in all clinical settings. Information technology (IT) can play an important role to prevent adverse drug events (ADEs), but data on the effectiveness of IT interventions are controversial. The objective of this paper is to provide a systematic review about the effects of IT interventions on medication safety in primary care.
  
  
  METHODS
  PubMed, International Pharmaceutical Abstracts, EMBASE, Cochrane Database of Systematic Reviews, handsearching reference lists from full-text articles.
  
  
  METHODS
  Randomized controlled trials (RCTs), if interventions based on IT, performed in primary care and outcomes reported on medication safety. Data extraction Study characteristics and outcome data independently extracted by two reviewers. Disagreement resolved by discussion with a third reviewer.
  
  
  RESULTS
  Out of 3918 studies retrieved, 10 RCTs met the inclusion criteria. Of the six studies evaluating computerized provider order entry (CPOE) with clinical decision support (CDS) only 3 studies effectively reduced unsafe prescribing. Both pharmacist-led IT interventions decreased the prescription of potentially inappropriate medication or unsafe prescribing in pregnancy. No reduction of ADEs was achieved by a web program or a TeleWatch system intervention.
  
  
  CONCLUSIONS
  Only 5 of 10 RCTs revealed a reduction of medication errors. CPOE with CDS was effective if targeted at a limited number of potentially inappropriate medications. The positive results of pharmacist-led IT interventions indicate that IT interventions with inter-professional communication appear to be effective. The unequivocal results of the included RCTs stress the necessity of rigorous evaluation prior to large-scale implementation.
authors.affiliation: Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Strubergasse 21, Salzburg 5020, Austria. miriam.lainer@pmu.ac.at.
authors.forename: Miriam
authors.initials: M
authors.lastname: Lainer
authors.forename: Eva
authors.initials: E
authors.lastname: Mann
authors.forename: Andreas
authors.initials: A
authors.lastname: Sönnichsen
mesh_terms: D006801:Humans; D008490:Medical Informatics; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D061214:Patient Safety; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D058996:Quality Improvement / Q000458:organization & administration
keywords: adverse drug events; clinical decision support; information technology; medication safety; primary care; systematic review