Evidence map›Paper›PMID 28956283›Full record

ArticleDrugs & aging2017

The Effect of Computerized Physician Order Entry Template Modifications on the Administration of High-Risk Medications in Older Adults in the Emergency Department.

Mitchell Kim, Stephen J Kaplan, Steven H Mitchell, Medley Gatewood, Itay Bentov, Katherine A Bennett, Carol A Crawford, Paul R Sutton, Diane Matsuwaka, Mamatha Damodarasamy and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Drugs & aging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 18% 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.

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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Implementation of geriatric clinical decision support in the emergency department for potentially inappropriate medications.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    Article
  3. Article
  4. Article
  5. Article
  6. Effect of Computerized Physician Order Entry and Clinical Decision Support System on Adverse Drug Events Prevention in the Emergency Department: A Systematic Review.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2021
    Review
  7. Integrity of clinical information in computerized order requisitions for diagnostic imaging.Journal of the American Medical Informatics Association : JAMIA · 2018
    Article
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

11 authors at 2 institutions in 1 country.

Mitchell KimDepartment of Emergency Medicine, University of Washington, Box 359702, 325 Ninth Avenue, Seattle, WA, USA. mitchkim87@gmail.com.ORCID 0000-0001-6493-760X
Stephen J KaplanDivision of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA.
Steven H MitchellDepartment of Emergency Medicine, University of Washington, Box 359702, 325 Ninth Avenue, Seattle, WA, USA.
Medley GatewoodDepartment of Emergency Medicine, University of Washington, Box 359702, 325 Ninth Avenue, Seattle, WA, USA.
Itay BentovDepartment of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Katherine A BennettDivision of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA.
Carol A CrawfordSchool of Pharmacy, University of Washington, Seattle, WA, USA.
Paul R SuttonDivision of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
Diane MatsuwakaSchool of Pharmacy, University of Washington, Seattle, WA, USA.
Mamatha DamodarasamyDivision of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA.
May J ReedDivision of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA.
University of Washington · USVirginia Mason Medical Center · US

Funding

Institute of Translational Health SciencesUL1TR000423 · NCATS · UNIVERSITY OF WASHINGTON · PI DISIS, MARY L. · 2012 to 2016
$49.4M
NCATS NIH HHS UL1 TR000423NCATS NIH HHS UL1TR000423
6 · The paper itself

Abstract

backgroundOlder adults are more susceptible to adverse events when administered certain medications at doses appropriate for younger adults.

objectiveThe aim of this study was to investigate the effect of default geriatric dosing on computerized physician order entry (CPOE) templates on the subsequent administration of recommended starting doses of opioids, benzodiazepines (BZDs) and non-steroidal anti-inflammatory drugs (NSAIDs) to older adults in the emergency department (ED).

methodsThis was a before-after comparison of the frequency of the recommended starting doses of high-risk medications to adults aged 65 years and older. Computerized records were queried for the administration of the above medication classes in two academic EDs over two similar 4-month periods in 2015 and 2016. Between study periods, the doses of high-risk medications on ED CPOE templates were adjusted for older adults based on established pharmacy guidelines and expert consensus.

resultsThere was a significant improvement in the rate of recommended dose administration of all medications of interest (27.3 vs. 32.5%, p < 0.001). Not surprisingly, the medications that were maximally impacted were also those most frequently prescribed, with a significant increase in the recommended dosing of opioids (29.0 vs. 35.2%, p < 0.001) accounting for the majority of the change. Although there were no differences in BZDs as a group, there were significant differences in selected BZDs such as midazolam and diazepam. Changes in the recommended dosing of NSAIDs could not be determined due to low numbers of administered doses in both phases of the study.

conclusionSimple changes in the CPOE template resulted in increased administration of the recommended starting doses of high-risk medications to older adults in the ED.

Indexed as

AdultAgedAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalBenzodiazepinesDrug PrescriptionsEmergency Service, HospitalFemaleHumansMedical Order Entry SystemsPharmaceutical PreparationsPractice Guidelines as TopicPractice Patterns, Physicians'Analgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalBenzodiazepinesPharmaceutical Preparations

Identifiers

PMID28956283
OpenAlexW2757368292

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.