Evidence map›Paper›PMID 18579832›Full record

SynthesisJournal of the American Medical Informatics Association : JAMIA

The effect of electronic prescribing on medication errors and adverse drug events: a systematic review.

Elske Ammenwerth, Petra Schnell-Inderst, Christof Machan, Uwe Siebert

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis 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 231 papers, 28 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
231citing papers in PubMed, 28 pooled it
–field-weighted citation impact
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

231 citing papers in PubMed, 28 syntheses or guidelines pooled it.

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  19. Effects of health information technology on patient outcomes: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2016
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171 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

4 authors.

Elske AmmenwerthUMIT-University for Health Sciences, Medical Informatics and Technology Tyrol, Institute for Health Information Systems, Tyrol, Austria. elske.ammenwerth@umit.at
Petra Schnell-Inderst
Christof Machan
Uwe Siebert

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The objective of this systematic review is to analyse the relative risk reduction on medication error and adverse drug events (ADE) by computerized physician order entry systems (CPOE). We included controlled field studies and pretest-posttest studies, evaluating all types of CPOE systems, drugs and clinical settings. We present the results in evidence tables, calculate the risk ratio with 95% confidence interval and perform subgroup analyses for categorical factors, such as the level of care, patient group, type of drug, type of system, functionality of the system, comparison group type, study design, and the method for detecting errors. Of the 25 studies that analysed the effects on the medication error rate, 23 showed a significant relative risk reduction of 13% to 99%. Six of the nine studies that analysed the effects on potential ADEs showed a significant relative risk reduction of 35% to 98%. Four of the seven studies that analysed the effect on ADEs showed a significant relative risk reduction of 30% to 84%. Reporting quality and study quality was often insufficient to exclude major sources of bias. Studies on home-grown systems, studies comparing electronic prescribing to handwriting prescribing, and studies using manual chart review to detect errors seem to show a higher relative risk reduction than other studies. Concluding, it seems that electronic prescribing can reduce the risk for medication errors and ADE. However, studies differ substantially in their setting, design, quality, and results. To further improve the evidence-base of health informatics, more randomized controlled trials (RCTs) are needed, especially to cover a wider range of clinical and geographic settings. In addition, reporting quality of health informatics evaluation studies has to be substantially improved.

Indexed as

Electronic PrescribingMedical Order Entry SystemsRisk ManagementHumansMedication ErrorsOdds Ratio

Identifiers

PMID18579832
PMCPMC2528040

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.