Medication Safety Alerts Frequently Ignored

Current alert system may be failing to ensure patient protection
By Jane Parry
HealthDay Reporter

TUESDAY, Feb. 10 (HealthDay News) -- Medication safety alerts, which are part of the decision support mechanism of electronic prescribing systems, are frequently overridden by clinicians and may not adequately protect patients, according to the results of a study published in the Feb. 9 issue of the Archives of Internal Medicine.

Thomas Isaac, M.D., of Beth Israel Deaconess Medical Center in Boston, and colleagues analyzed data on 233,537 medication safety alerts that were generated by 2,872 clinicians using an electronic prescribing system. In all, 6.6 percent of prescriptions triggered alerts.

Although 61.6 percent of alerts were due to high-severity drug interactions, clinicians only accepted between 2.2 percent and 43.1 percent of them, depending on the drugs involved, and overall only 9.2 percent of drug interaction and 23 percent of allergy alerts were accepted by clinicians, the investigators found. Past experience affected the likelihood of overriding an alert; patients who had previously received the medication that triggered the alert were more likely to be prescribed the drug again, the researchers report.

"Clinicians' responses to medication safety alerts have much to teach us. Clinicians override most alerts, suggesting that existing alerts may provide little value to practitioners," the authors write. "Unless designers take steps to improve prescription alert systems, the potential benefits of electronic prescribing may not be realized."

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