Trial reportJournal of the American Medical Informatics Association : JAMIA
Randomized trial to improve prescribing safety during pregnancy.
Trial report in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
13 citing papers in PubMed, 6 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- How does the Content and Dissemination of Communications on the Risks of Medicines Affect Prescriber Awareness, Knowledge, and Behaviour: A Systematic Review.Drug safety · 2026Pooled it
- How intervention studies measure the effectiveness of medication safety-related clinical decision support systems in primary and long-term care: a systematic review.BMC medical informatics and decision making · 2024Pooled it
- The evidence for the effectiveness of safety alerts in electronic patient medication record systems at the point of pharmacy order entry: a systematic review.BMC medical informatics and decision making · 2013Pooled it
- Computerized clinical decision support systems for drug prescribing and management: a decision-maker-researcher partnership systematic review.Implementation science : IS · 2011Pooled it
- Features predicting the success of computerized decision support for prescribing: a systematic review of randomized controlled trials.BMC medical informatics and decision making · 2009Pooled it
- The effectiveness of integrated health information technologies across the phases of medication management: a systematic review of randomized controlled trials.Journal of the American Medical Informatics Association : JAMIAPooled it
- Clinical decision support to promote safe prescribing to women of reproductive age: a cluster-randomized trial.Journal of general internal medicine · 2012Trial
- Randomized clinical trial of a customized electronic alert requiring an affirmative response compared to a control group receiving a commercial passive CPOE alert: NSAID--warfarin co-prescribing as a test case.Journal of the American Medical Informatics Association : JAMIATrial
- Standards for Reporting Implementation Studies (StaRI): explanation and elaboration document.BMJ open · 2017Article
- Assessing the safety features of electronic patient medication record systems used in community pharmacies in England.British journal of clinical pharmacology · 2014Article
- Counseling about medication-induced birth defects with clinical decision support in primary care.Journal of women's health (2002) · 2013Article
- Counseling of female veterans about risks of medication-induced birth defects.Journal of general internal medicine · 2013Article
- Detecting pregnancy use of non-hormonal category X medications in electronic medical records.Journal of the American Medical Informatics Association : JAMIA · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThis study sought to determine whether a computerized tool that alerted pharmacists when pregnant patients were prescribed U.S. Food and Drug Administration pregnancy risk category D or X medications was effective in decreasing dispensings of these medications.
designRandomized trial. Pharmacy, diagnostic, and laboratory data were linked to identify pregnant patients prescribed targeted medications. Women (n = 11,100) were randomized to intervention or usual care. Physicians and pharmacists collaborated on the intervention. MEASUREMENTS: The primary outcome was the proportion of pregnant women dispensed a category D or X medication. The secondary outcome was the total number of first dispensings of targeted medications.
resultsA total of 2.9% of intervention (n = 177) and 5.5% of usual care (n = 276) patients were dispensed targeted medications (p < 0.001): 1.8% of intervention (n = 108) and 3.9% of usual care (n = 198) patients were dispensed only category D medication(s); 0.9% of intervention (n = 54) and 1.2% of usual care (n = 58) patients were dispensed only category X medication(s); 0.2% of intervention (n = 15) and 0.4% of usual care (n = 20) patients were dispensed both category D and X medications (p = 0.05). This resulted in intervention patients receiving 238 dispensings of unique targeted medications and usual care patients receiving 361 dispensings of unique targeted medications (p = 0.03). The study was stopped primarily due to 2 false-positive alert types: Misidentification of medications as contraindicated in pregnancy by the pharmacy information system and misidentification of pregnancy related to delayed transfer of diagnosis information.
conclusionCoupling data from information systems with knowledge and skills of physicians and pharmacists resulted in improved prescribing safety. Systems limitations contributed to project discontinuation. Linking ambulatory clinical, laboratory, and pharmacy information to provide safety alerts is not sufficient to ensure project success and sustainability.
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Registered trials
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.