The Effect of Computerized Physician Order Entry with Clinical Decision Support on the Rates of Adverse Drug Events: A Systematic Review

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The purpose of this article is to quantify what impact, if any, computerized physician order entry (CPOE) with clinical decision support systems (CDSS) have had in the development of adverse drug events (ADE). [1]


Randomized and nonrandomized clinical trials as well as studies were analyzed to determine their “the effect on the rates of ADEs when CPOE with CDSS were utilized. The studies kept track of the types of the system, ADEs, drug categories, and the final outcome. [1]


10 studies out of the 543 originally evaluated qualified for the criteria of this study. The studies were classified as applying to either ‘hospital’ or ‘ambulatory’ and had the following results: [1]

  • 50% of the studies had statistically significant decrease in ADE rates
  • 40% of the studies had non-statistically significant decrease in ADE rates
  • 10% of the studies reported no change in ADE rates


There have been very few studies performed on the effect CPOE with CDSS have on ADEs. Further research will need to be conducted in order to accurately quantify the impact CPOE with CDSS are capable of achieving in clinical settings.


Adverse drug events should be prevented as much as possible. CPOE with CDSS have shown they can be an effective tool in assisting with this task. I agree with the article’s conclusion recommendation for further research to be conducted as it might lead to figuring out how method of implementing CPOE with CDSS which obtains statistically significant reduction in ADE rates in all settings, and not just half.


  1. 1.0 1.1 1.2 Wolfstadt, J. I., Gurwitz, J. H., Field, T. S., Lee, M., Kalkar, S., Wu, W., & Rochon, P. A. (2008). The effect of computerized physician order entry with clinical decision support on the rates of adverse drug events: a systematic review. Journal of General Internal Medicine, 23(4), 451-458.