J Am Med Inform Assoc - How to improve the delivery of medication alerts within computerized physician order entry systems: an international Delphi study.

Tópicos

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Resumo

JECTIVES: To determine what information can be helpful in prioritizing and presenting medication alerts according to the context of the clinical situation. To assess the usefulness of different ways of delivering medication alerts to the user.DESIGN: An international Delphi study with two quantitative rounds. 69 researchers with expertise in computerized physician order entry (CPOE) systems were asked to estimate the usefulness of 20 possible context factors, and to assess the potential impact of six innovative ways of delivering alert information on adverse drug event (ADE) rates.RESULTS: Participants identified the following top five context information items (in descending order of usefulness): (1) severity of the effect of the ADE the alert refers to; (2) clinical status of the patient; (3) probability of occurrence of the ADE the alert refers to; (4) risk factors of the patient; and (5) strength of evidence on which the alert is built. The ways of delivering alert information with the highest estimated ADE reduction potential are active alerting, proactive prescription simulation and a patient medication module that gives patient-oriented alert information.LIMITATIONS: Most participants had a research-oriented focus; therefore the results may not reflect the opinions of CPOE users or CPOE implementers.CONCLUSION: The study results may provide CPOE system developers and healthcare institutions with information on how to design more effective alert mechanisms.

Resumo Limpo

jectiv determin inform can help priorit present medic alert accord context clinic situat assess use differ way deliv medic alert userdesign intern delphi studi two quantit round research expertis computer physician order entri cpoe system ask estim use possibl context factor assess potenti impact six innov way deliv alert inform advers drug event ade ratesresult particip identifi follow top five context inform item descend order use sever effect ade alert refer clinic status patient probabl occurr ade alert refer risk factor patient strength evid alert built way deliv alert inform highest estim ade reduct potenti activ alert proactiv prescript simul patient medic modul give patientori alert informationlimit particip researchori focus therefor result may reflect opinion cpoe user cpoe implementersconclus studi result may provid cpoe system develop healthcar institut inform design effect alert mechan

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