Trial reportJournal of the American Medical Informatics Association : JAMIA
A randomized trial of electronic clinical reminders to improve medication laboratory monitoring.
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 22 papers, 11 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
22 citing papers in PubMed, 11 syntheses or guidelines pooled it.
- Digital patient safety interventions in primary care: a systematic review and meta-analysis.BMC medicine · 2026Pooled it
- The Effect of Laboratory Test-Based Clinical Decision Support Tools on Medication Errors and Adverse Drug Events: A Laboratory Medicine Best Practices Systematic Review.The journal of applied laboratory medicine · 2019Pooled it
- Computerized advice on drug dosage to improve prescribing practice.The Cochrane database of systematic reviews · 2013Pooled it
- Changing clinical practice through patient specific reminders available at the time of the clinical encounter: systematic review and meta-analysis.Journal of general internal medicine · 2012Pooled it
- Biochemical monitoring of patients treated with antihypertensive therapy for adverse drug reactions: a systematic review.Drug safety · 2011Pooled it
- Computerized clinical decision support systems for drug prescribing and management: a decision-maker-researcher partnership systematic review.Implementation science : IS · 2011Pooled it
- Can computerized clinical decision support systems improve practitioners' diagnostic test ordering behavior? A decision-maker-researcher partnership systematic review.Implementation science : IS · 2011Pooled it
- Computerized clinical decision support systems for therapeutic drug monitoring and dosing: a decision-maker-researcher partnership systematic review.Implementation science : IS · 2011Pooled it
- The effects of on-screen, point of care computer reminders on processes and outcomes of care.The Cochrane database of systematic reviews · 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
- Impact of health information technology interventions to improve medication laboratory monitoring for ambulatory patients: a systematic review.Journal of the American Medical Informatics Association : JAMIAPooled it
- Impact of non-interruptive medication laboratory monitoring alerts in ambulatory care.Journal of the American Medical Informatics Association : JAMIATrial
- Practical guide for determining whether healthcare providers are research participants in cluster randomised trials.BMJ open · 2026Review
- The Current State of Patient Adherence to Lab Monitoring Guidelines for Janus Kinase Inhibitors in Patients with Alopecia Areata.The Journal of clinical and aesthetic dermatology · 2025Article
- Efficiency over thoroughness in laboratory testing decision making in primary care: findings from a realist review.BJGP open · 2021Article
- Clinician preferences for computerised clinical decision support for medications in primary care: a focus group study.BMJ health & care informatics · 2019Article
- Analysis of clinical decision support system malfunctions: a case series and survey.Journal of the American Medical Informatics Association : JAMIA · 2016Article
- Factors associated with ordering laboratory monitoring of high-risk medications.Journal of general internal medicine · 2014Article
- From evidence to best practice in laboratory medicine.The Clinical biochemist. Reviews · 2013Review
- Patient completion of laboratory tests to monitor medication therapy: a mixed-methods study.Journal of general internal medicine · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectiveRecommendations for routine laboratory monitoring to reduce the risk of adverse medication events are not consistently followed. We evaluated the impact of electronic reminders delivered to primary care physicians on rates of appropriate routine medication laboratory monitoring.
designWe enrolled 303 primary care physicians caring for 1,922 patients across 20 ambulatory clinics that had at least one overdue routine laboratory test for a given medication between January and June 2004. Clinics were randomized so that physicians received either usual care or electronic reminders at the time of office visits focused on potassium, creatinine, liver function, thyroid function, and therapeutic drug levels. MEASUREMENTS: Primary outcomes were the receipt of recommended laboratory monitoring within 14 days following an outpatient clinic visit. The effect of the intervention was assessed for each reminder after adjusting for clustering within clinics, as well as patient and provider characteristics.
resultsMedication-laboratory monitoring non-compliance ranged from 1.6% (potassium monitoring with potassium-supplement use) to 6.3% (liver function monitoring with HMG CoA Reductase Inhibitor use). Rates of appropriate laboratory monitoring following an outpatient visit ranged from 14% (therapeutic drug levels) to 64% (potassium monitoring with potassium-sparing diuretic use). Reminders for appropriate laboratory monitoring had no impact on rates of receiving appropriate testing for creatinine, potassium, liver function, renal function, or therapeutic drug level monitoring.
conclusionWe identified high rates of appropriate laboratory monitoring, and electronic reminders did not significantly improve these monitoring rates. Future studies should focus on settings with lower baseline adherence rates and alternate drug-laboratory combinations.
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