Trial reportJournal of the American Medical Informatics Association : JAMIA
Impact of non-interruptive medication laboratory monitoring alerts in ambulatory care.
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 34 papers, 8 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
34 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Electronic Health Record Nudges and Health Care Quality and Outcomes in Primary Care: A Systematic Review.JAMA network open · 2024Pooled 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
- The effects of on-screen, point of care computer reminders on processes and outcomes of care.The Cochrane database of systematic reviews · 2009Pooled 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
- 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
- Risk Model-Guided Clinical Decision Support for Suicide Screening: A Randomized Clinical Trial.JAMA network open · 2025Trial
- A randomized controlled trial to provide adherence information and motivational interviewing to improve diabetes and lipid control.The Diabetes educator · 2015Trial
- Efficacy of a clinical decision-support system in an HIV practice: a randomized trial.Annals of internal medicine · 2012Trial
- Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors.Journal of the American Medical Informatics Association : JAMIATrial
- Lessons Learned from the Usability Assessment of an EHR-Based Tool to Support Adherence to Antihypertensive Medications.Applied clinical informatics · 2025Article
- Interventions to improve appropriateness of laboratory testing in the intensive care unit: a narrative review.Annals of intensive care · 2024Review
- Impact of Kidney Failure Risk Prediction Clinical Decision Support on Monitoring and Referral in Primary Care Management of CKD: A Randomized Pragmatic Clinical Trial.Kidney medicine · 2022Article
- Efficiency over thoroughness in laboratory testing decision making in primary care: findings from a realist review.BJGP open · 2021Article
- Use of Electronic Health Record Access and Audit Logs to Identify Physician Actions Following Noninterruptive Alert Opening: Descriptive Study.JMIR medical informatics · 2019Article
- Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.Journal of the American Medical Informatics Association : JAMIA · 2018Article
- Electronic alerts, comparative practitioner metrics, and education improve thromboprophylaxis and reduce venous thrombosis in community hospitals.Research and practice in thrombosis and haemostasis · 2018Article
- Impact of nonintrusive clinical decision support systems on laboratory test utilization in a large academic centre.Journal of evaluation in clinical practice · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveInterruptive alerts within electronic applications can cause "alert fatigue" if they fire too frequently or are clinically reasonable only some of the time. We assessed the impact of non-interruptive, real-time medication laboratory alerts on provider lab test ordering.
designWe enrolled 22 outpatient practices into a prospective, randomized, controlled trial. Clinics either used the existing system or received on-screen recommendations for baseline laboratory tests when prescribing new medications. Since the warnings were non-interruptive, providers did not have to act upon or acknowledge the notification to complete a medication request. MEASUREMENTS: Data were collected each time providers performed suggested laboratory testing within 14 days of a new prescription order. Findings were adjusted for patient and provider characteristics as well as patient clustering within clinics.
resultsAmong 12 clinics with 191 providers in the control group and 10 clinics with 175 providers in the intervention group, there were 3673 total events where baseline lab tests would have been advised: 1988 events in the control group and 1685 in the intervention group. In the control group, baseline labs were requested for 771 (39%) of the medications. In the intervention group, baseline labs were ordered by clinicians in 689 (41%) of the cases. Overall, no significant association existed between the intervention and the rate of ordering appropriate baseline laboratory tests.
conclusionWe found that non-interruptive medication laboratory monitoring alerts were not effective in improving receipt of recommended baseline laboratory test monitoring for medications. Further work is necessary to optimize compliance with non-critical recommendations.
Indexed as
Identifiers
What OpenQuestion holds
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.