Evidence map›Paper›PMID 22246963›Full record

Trial reportJournal of the American Medical Informatics Association : JAMIA

The effectiveness of a new generation of computerized drug alerts in reducing the risk of injury from drug side effects: a cluster randomized trial.

Robyn Tamblyn, Tewodros Eguale, David L Buckeridge, Allen Huang, James Hanley, Kristen Reidel, Sherry Shi, Nancy Winslade

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

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. It is linked to trial NCT00818285 (Reducing Injuries From Medication-Related Falls by Generating Targeted Computerized Alerts for High Risk Patients Within an Electronic Prescribing System), which is not on this map. Cited by 42 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 15 pooled it
7.3field-weighted citation impact, top 3% 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.

NCT00818285 nacompletednot on this map

Reducing Injuries From Medication-Related Falls by Generating Targeted Computerized Alerts for High Risk Patients Within an Electronic Prescribing System

TypeinterventionalSponsorMcGill UniversityRan2008 to 2012Enrolled5,628ConditionsFall Related Injury RiskArmsCDS for psychotropic drug management
3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 15 syntheses or guidelines pooled it, 88 citations in OpenAlex.

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  14. Computerized advice on drug dosage to improve prescribing practice.The Cochrane database of systematic reviews · 2013
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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 Epidemiology & Biostatistics, McGill University, Montreal, Quebec, Canada. robyn.tamblyn@mcgill.ca
Tewodros Eguale
David L Buckeridge
Allen Huang
James Hanley
Kristen Reidel
Sherry Shi
Nancy Winslade
McGill University · CA

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

contextComputerized drug alerts for psychotropic drugs are expected to reduce fall-related injuries in older adults. However, physicians over-ride most alerts because they believe the benefit of the drugs exceeds the risk.

objectiveTo determine whether computerized prescribing decision support with patient-specific risk estimates would increase physician response to psychotropic drug alerts and reduce injury risk in older people.

designCluster randomized controlled trial of 81 family physicians and 5628 of their patients aged 65 and older who were prescribed psychotropic medication.

interventionIntervention physicians received information about patient-specific risk of injury computed at the time of each visit using statistical models of non-modifiable risk factors and psychotropic drug doses. Risk thermometers presented changes in absolute and relative risk with each change in drug treatment. Control physicians received commercial drug alerts.

main outcome measuresInjury risk at the end of follow-up based on psychotropic drug doses and non-modifiable risk factors. Electronic health records and provincial insurance administrative data were used to measure outcomes.

resultsMean patient age was 75.2 years. Baseline risk of injury was 3.94 per 100 patients per year. Intermediate-acting benzodiazepines (56.2%) were the most common psychotropic drug. Intervention physicians reviewed therapy in 83.3% of visits and modified therapy in 24.6%. The intervention reduced the risk of injury by 1.7 injuries per 1000 patients (95% CI 0.2/1000 to 3.2/1000; p=0.02). The effect of the intervention was greater for patients with higher baseline risks of injury (p<0.03).

conclusionPatient-specific risk estimates provide an effective method of reducing the risk of injury for high-risk older people. TRIAL REGISTRATION NUMBER: clinicaltrials.gov Identifier: NCT00818285.

Indexed as

Medical Order Entry SystemsPractice Patterns, Physicians'Accidental FallsAgedComputer GraphicsDecision Support Systems, ClinicalDrug Therapy, Computer-AssistedFemaleHumansMalePsychotropic DrugsQuebecRisk AssessmentPsychotropic Drugs

Identifiers

PMID22246963
PMCPMC3384117
OpenAlexW2098415242

What OpenQuestion holds

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LicenceCC BY-NC
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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.