title: Systems that prevent unwanted represcription of drugs withdrawn because of adverse drug events: a systematic review.
abstract: Represcription of medication that was withdrawn after the occurrence of an adverse drug event (including allergy), is a recognized medication safety issue on a patient level. We performed a systematic review to identify systems (electronic and nonelectronic) that can prevent the represcription of drugs withdrawn because of an adverse drug event and the effects of these systems. The review was performed using PRISMA and Cochrane guidelines. PubMed and Embase were searched for articles describing systems that can prevent represcription of drugs that had been withdrawn for causing an adverse drug event. Information on the characteristics of the studies, systems, and if present results achieved with such systems, was extracted. The results showed that of 6793 articles screened, 137 full-text articles were assessed for eligibility. A total of 45 studies describing 33 systems (28 electronic) were included. The five nonelectronic systems used allergy bracelets or allergy labels on hospital medical records or on drug orders. Systems differed in the way adverse drug events were documented and how users were alerted to drug represcription. Most systems functioned within a specific healthcare setting. Of 12 studies that compared pre- and post-intervention periods or wards with and without intervention, 7 showed a reduction in represcription after adverse drug event. In conclusion, several systems have been developed that can prevent the represcription of drugs that elicited an adverse drug event, but the evidence that these systems are effective is limited.
authors.affiliation: Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, the Netherlands.
authors.forename: Carolien M J
authors.initials: CM
authors.lastname: van der Linden
authors.affiliation: Department of Geriatrics, University Medical Centre Utrecht, and EPHOR Expertise Centre Pharmacotherapy in Old Persons, the Netherlands.
authors.forename: Paul A F
authors.initials: PA
authors.lastname: Jansen
authors.affiliation: Catharina Hospital Eindhoven, the Netherlands.
authors.forename: René J E
authors.initials: RJ
authors.lastname: Grouls
authors.affiliation: Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van Marum
authors.forename: Marianne A J W
authors.initials: MA
authors.lastname: Verberne
authors.affiliation: Medical Student, Maastricht University, the Netherlands.
authors.forename: Lieke M A
authors.initials: LM
authors.lastname: Aussems
authors.affiliation: Hospital Pharmacist, University Medical Centre Utrecht and Utrecht Institute for Pharmaceutical Sciences Utrecht, the Netherlands.
authors.forename: Toine C G
authors.initials: TC
authors.lastname: Egberts
authors.affiliation: Anesthesiologist, Catharina Hospital Eindhoven and Eindhoven University of Technology, the Netherlands.
authors.forename: Erik H M
authors.initials: EH
authors.lastname: Korsten
keywords: adverse drug event; allergy; clinical decision support; computerized physician order entry
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