Randomized clinical trial of a customized electronic alert requiring an affirmative response compared to a control group receiving a commercial passive CPOE alert: NSAID–warfarin co-prescribing as a test case
This is a review from the Journal of the American Medical Informatics Association and the article is Randomized clinical trial of a customized electronic alert requiring an affirmative response compared to a control group receiving a commercial passive CPOE alert: NSAID-warfarin co prescribing as a test case.
What is the leading cause of death in American Hospitals? Medication errors is the leading cause. There are several studies show medication errors with the use of Computer physician order entry (CPOE). Medication errors can be described in two categories such as errors of omission and errors of commission.This study is looking at the effectiveness of computerized decision support systems to prevent drug-drug interactions.
- University of Pennsylvania
- Sunrise Clinical Manager CPOE System
- Resident Physicians
- Nurser Practitioners
- Inpatient Care
- Study dates - August 2, 2006 - December 15, 2007
Study Groups The study was designed to activate an alert when ever a resident physician or nurse practitioners placed an order for a NSAID with an already active warfarin order.
Data Collection The study was analysis was when the alert was fired or would have fired. DId the alert fire whenever a prescription order for a concurrent NSAID and warfarin was encountered during the inpatient stay. if multiple alerts fired within 5 minutes or less it was considered a single episode, but if the alerts fired 5 minutes or more apart they where considered different episodes. The study would measure the alerts response between the groups. 
The trend over the study period with decreasing proportion of desired ordering responses over time. The study showed no group difference.
It was interesting to see that the study had no effect in reducing concomitant prescribing the two medications when compared to the usual standard of care.
- Strom, B. L., Schinnar, R., Bilker, W., Hennessy, S., Leonard, C. E., & Pifer, E. (2010). Randomized clinical trial of a customized electronic alert requiring an affirmative response compared to a control group receiving a commercial passive CPOE alert: NSAID—warfarin co-prescribing as a test case. Journal of the American Medical Informatics Association, 17(4), 411-415.