Difference between revisions of "Impact of Health Information Technology on Detection of Potential Adverse Drug Events at the Ordering Stage"

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== Results ==
 
== Results ==
There was a significant increase in the number of potential ADE alerts in the group of hospitals with HIT implementation and a marked decrease in the number of times physicians were contacted in this group as compared to the group without HIT implementation. Although most of the alerts reviewed by pharmacists were false-positives, the true number of true-positive alerts increased with the number of admissions.
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There was a significant increase in the number of potential [[Adverse drug event]](ADE) alerts in the group of hospitals with HIT implementation and a marked decrease in the number of times physicians were contacted in this group as compared to the group without HIT implementation. Although most of the alerts reviewed by pharmacists were false-positives, the true number of true-positive alerts increased with the number of admissions.
  
 
== Conclusion ==
 
== Conclusion ==

Revision as of 21:05, 6 April 2015

This is a review of Roberts, L.L., Ward, M.M., Brokel, J.M., Wakefield, D.S, Crandall, D.K & Conlon, P. (2010). Impact of Health Information Technology on Detection of Potential Adverse Drug Events at the Ordering Stage[1]

Objective

To study how health information technology (HIT) implementation was instrumental in detecting adverse drug events (ADEs) at the medication ordering stage.

Methods

The study was carried out at two experimental groups of hospitals in a large health system over 28 months. At hospitals without HIT implementation, using a pharmacy information system interface, pharmacists checked physicians’ handwritten medication orders for ADEs. At hospitals with implementation of EHR, CPOE and CDSS, data and alerts of potential ADEs at the medication ordering stage were compared with those from hospitals without HIT implementation. Data analysis involved determining the mean response profile of six dependent variables for each experimental group using a mixed-effects model.

Results

There was a significant increase in the number of potential Adverse drug event(ADE) alerts in the group of hospitals with HIT implementation and a marked decrease in the number of times physicians were contacted in this group as compared to the group without HIT implementation. Although most of the alerts reviewed by pharmacists were false-positives, the true number of true-positive alerts increased with the number of admissions.

Conclusion

With the implementation of HIT, a significant number of potential ADE alerts were detected. Hospitals with CPOE and CDSS showed more increase in the number of ADE alerts. The number of true-positive alerts reviewed by pharmacists showed an increase with the number of patient admissions.

Discussion

The study showed that the proportion of true-positive alerts of potential ADEs without HIT implementation was greater than for the group with HIT. Pharmacists played an important and effective role in reviewing ADE alerts. With HIT implementation, there were fewer physician contacts by pharmacists for ADE alerts, and physicians were in more agreement with pharmacists’ recommendations. The implementation of CPOE and CDSS generally improved ADE detection and patient safety.

References

  1. Roberts, L.L., Ward, M.M., Brokel, J.M., Wakefield, D.S, Crandall, D.K & Conlon, P. (2010). Impact of Health Information Technology on Detection of Potential Adverse Drug Events at the Ordering Stage. http://ca3cx5qj7w.search.serialssolutions.com/OpenURL_local?sid=Entrez:PubMed&id=pmid:20966148/