Do computerised clinical decision support systems for prescribing change practice? A systematic review of the literature (1990-2007)
Publications contained in the Medline , Embase , and PsychINFO  databases from 1990-2007 were examined in order to find studies regarding clinical decision support systems which contained interventions for interventions. Reviewers independently analyzed the studies to determine what outcomes the systems being reviewed has on prescriptions .
A total of 56 studies met the criteria for this study: 38 dealt with initiating therapy, 23 focused on monitoring therapy, and 3 focused on stopping therapy. Of the 38 studies regarding initiating therapy 36 studies showed improvement with 19 showing significant improvements. 18 of the 23 studies on monitoring therapy showed improvements with 8 having statistically significant improvements. Studies on stopping therapy were too few to fully analyze. However, 0 out of the 3 studies found had improvements with 1 study showed that CDSS had slightly made things worse.
The article concludes there is not yet enough information to form a thorough understanding on the effect of CDSS on the prescribing process, and hopes future CDSS implementations are modeled after the successful strategies which have been utilized thus far.
I agree with the article’s conclusion. The results on initiating and monitoring therapy showed improvement in the majority of cases, but only showed significant improvement in about half of the studies, and none of the studies from stopping therapy showed any improvement at all. This seems to suggest the implementation strategies are hit or miss at the moment; but that can only improve as a more thorough understanding of CDSS regarding prescription increases and we learn more about why the successful implementations were successful.
- Pearson, S. A., Moxey, A., Robertson, J., Hains, I., Williamson, M., Reeve, J., & Newby, D. (2009). Do computerised clinical decision support systems for prescribing change practice? A systematic review of the literature (1990-2007). BMC health services research, 9(1), 154. http://www.biomedcentral.com/1472-6963/9/154