J Am Med Inform Assoc - Don't fuel the fire: decreasing intravenous haloperidol use in high risk patients via a customized electronic alert.

Tópicos

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Resumo

Delivering useful clinical decision support to providers who are ordering high risk drugs for high risk patients is imperative for safe pharmacotherapy. This paper presents a focused electronic clinical decision support intervention designed to decrease the risk of corrected QT interval (QTc) related adverse drug events in a high risk patient population. Results showed that a customized alert can both decrease the number of alerts sent to providers while still improving the safety of prescribing practices for intravenous haloperidol. The alert leveraged components of the electronic health record to significantly decrease the rate of inappropriate prescription of intravenous haloperidol in patients with QTc >500 ms from 50% to 14%. The results also suggest providers may abandon the appropriate prescription of a medication in response to an alert. The findings support the necessity of careful targeting of electronic alerts and monitoring for unintended consequences when implementing these types of electronic alerts.

Resumo Limpo

deliv use clinic decis support provid order high risk drug high risk patient imper safe pharmacotherapi paper present focus electron clinic decis support intervent design decreas risk correct qt interv qtc relat advers drug event high risk patient popul result show custom alert can decreas number alert sent provid still improv safeti prescrib practic intraven haloperidol alert leverag compon electron health record signific decreas rate inappropri prescript intraven haloperidol patient qtc ms result also suggest provid may abandon appropri prescript medic respons alert find support necess care target electron alert monitor unintend consequ implement type electron alert

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