Evidence map›Paper›PMID 12975221›Full record

Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2003

The medical office of the 21st century (MOXXI): effectiveness of computerized decision-making support in reducing inappropriate prescribing in primary care.

Robyn Tamblyn, Allen Huang, Robert Perreault, André Jacques, Denis Roy, James Hanley, Peter McLeod, Réjean Laprise

Open access · greenAbstract readClinical TrialComparative StudyRandomized Controlled Trial
PubMed Full text at PMC
In one paragraph

Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 132 papers, 30 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
132citing papers in PubMed, 30 pooled it
14.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

132 citing papers in PubMed, 30 syntheses or guidelines pooled it, 298 citations in OpenAlex.

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  2. Effect of electronic drug-drug interaction alerts on patient and clinician outcomes: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2025
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  16. Computerized advice on drug dosage to improve prescribing practice.The Cochrane database of systematic reviews · 2013
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72 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Robyn TamblynDepartment of Medicine, McGill University, Montreal, Que. robyn.tamblyn@mcgill.ca
Allen Huang
Robert Perreault
André Jacques
Denis Roy
James Hanley
Peter McLeod
Réjean Laprise
McGill University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdverse drug-related events are common in the elderly, and inappropriate prescribing is a preventable risk factor. Our objective was to determine whether inappropriate prescribing could be reduced when primary care physicians had computer-based access to information on all prescriptions dispensed and automated alerts for potential prescribing problems.

methodsWe randomly assigned 107 primary care physicians with at least 100 patients aged 66 years and older (total 12 560) to a group receiving computerized decision-making support (CDS) or a control group. Physicians in the CDS group had access to information on current and past prescriptions through a dedicated computer link to the provincial seniors' drug-insurance program. When any of 159 clinically relevant prescribing problems were identified by the CDS software, the physician received an alert that identified the nature of the problem, possible consequences and alternative therapy. The rate of initiation and discontinuation of potentially inappropriate prescriptions was assessed over a 13-month period.

resultsIn the 2 months before the study, 31.8% of the patients in the CDS group and 33.3% of those in the control group had at least 1 potentially inappropriate prescription. During the study the number of new potentially inappropriate prescriptions per 1000 visits was significantly lower (18%) in the CDS group than in the control group (relative rate [RR] 0.82, 95% confidence interval [CI] 0.69-0.98), but differences between the groups in the rate of discontinuation of potentially inappropriate prescriptions were significant only for therapeutic duplication by the study physician and another physician (RR 1.66, 95% CI 0.99-2.79) and drug interactions caused by prescriptions written by the study physician (RR 2.15, 95% CI 0.98-4.70).

interpretationComputer-based access to complete drug profiles and alerts about potential prescribing problems reduces the rate of initiation of potentially inappropriate prescriptions but has a more selective effect on the discontinuation of such prescriptions.

Indexed as

Clinical Pharmacy Information SystemsDecision Support Systems, ClinicalDrug Therapy, Computer-AssistedAdultAgedAged, 80 and overDrug Information ServicesDrug InteractionsDrug PrescriptionsDrug UtilizationFemaleHealth Services MisuseHumansInsurance, Pharmaceutical ServicesMaleMedication Errors

Identifiers

PMID12975221
PMCPMC191278
OpenAlexW2117162256

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.