ArticleJournal of the American Medical Informatics Association : JAMIA2018
The national cost of adverse drug events resulting from inappropriate medication-related alert overrides in the United States.
Article in Journal of the American Medical Informatics Association : JAMIA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Criteria to Report Adverse Drug Withdrawal Events in Clinical Trials: A Systematic Review.Journal of the American Geriatrics Society · 2025Pooled it
- How intervention studies measure the effectiveness of medication safety-related clinical decision support systems in primary and long-term care: a systematic review.BMC medical informatics and decision making · 2024Pooled it
- Verification of the value of optimization of the medication-related clinical decision support system in China, a hospital-based study.JAMIA open · 2026Article
- Code-Based Versus AutoML Methods for Pill Recognition in Clinical Settings: Comparative Performance Study.JMIR medical informatics · 2026Article
- Design Principles for Interactive Dashboards in Drug Safety Surveillance: Design Science Research.JMIR medical informatics · 2026Article
- Benchmarking large language models for replication of guideline-based PGx recommendations.The pharmacogenomics journal · 2025Article
- Advantages and Inconveniences of a Multi-Agent Large Language Model System to Mitigate Cognitive Biases in Diagnostic Challenges.Journal of medical Internet research · 2025Article
- Large language models management of complex medication regimens: a case-based evaluation.Frontiers in pharmacology · 2025Article
- Development and Implementation of a Clinical Decision Support System to Enhance Efficiency and Accuracy in Medication Prescription Review in a Tertiary Care Hospital: A Retrospective Hospital CDSS Register Study.Journal of multidisciplinary healthcare · 2025Article
- Barriers to medication administration error reporting in a tertiary hospital in Lebanon.BMJ open quality · 2024Article
- Deciphering the Intricate Interplay in the Framework of Antibiotic-Drug Interactions: A Narrative Review.Antibiotics (Basel, Switzerland) · 2024Review
- Evaluating the costs of adverse drug events in hospitalized patients: a systematic review.Health economics review · 2024Review
- Deviations From Best Practice: Findings From a Certified Patient Safety Organization Remote-Verification Observational Study of Intravenous Compounding of Chemotherapeutic and Ancillary Drugs.Journal of pharmacy practice · 2023Observational
- An Exploratory Analysis of the Association between Hospital Quality Measures and Financial Performance.Healthcare (Basel, Switzerland) · 2023Article
- Dose adjustment of rheumatology and allergy/immunology medications in chronic kidney disease: awareness and knowledge among internal medicine housestaff.Proceedings (Baylor University. Medical Center) · 2023Article
- Critical Care Pharmacists: Improving Care by Increasing Access to Medication Expertise.Annals of the American Thoracic Society · 2022Article
- An e-Delphi study to obtain expert consensus on the level of risk associated with preventable e-prescribing events.British journal of clinical pharmacology · 2022Article
- Habit and Automaticity in Medical Alert Override: Cohort Study.Journal of medical Internet research · 2022Article
- Pharmacogenomics driven decision support prototype with machine learning: A framework for improving patient care.Frontiers in big data · 2022Article
- Prevalence of potentially harmful multidrug interactions on medication lists of elderly ambulatory patients.BMC geriatrics · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Objective: To estimate the national cost of ADEs resulting from inappropriate medication-related alert overrides in the U.S. inpatient setting. Materials and Methods: We used three different regression models (Basic, Model 1, Model 2) with model inputs taken from the medical literature. A random sample of 40 990 adult inpatients at the Brigham and Women's Hospital (BWH) in Boston with a total of 1 639 294 medication orders was taken. We extrapolated BWH medication orders using 2014 National Inpatient Sample (NIS) data. Results: Using three regression models, we estimated that 29.7 million adult inpatient discharges in 2014 resulted in between 1.02 billion and 1.07 billion medication orders, which in turn generated between 75.1 million and 78.8 million medication alerts, respectively. Taking the basic model (78.8 million), we estimated that 5.5 million medication-related alerts might have been inappropriately overridden, resulting in approximately 196 600 ADEs nationally. This was projected to cost between $871 million and $1.8 billion for treating preventable ADEs. We also estimated that clinicians and pharmacists would have jointly spent 175 000 hours responding to 78.8 million alerts with an opportunity cost of $16.9 million. Discussion and Conclusion: These data suggest that further optimization of hospitals computerized provider order entry systems and their associated clinical decision support is needed and would result in substantial savings. We have erred on the side of caution in developing this range, taking two conservative cost estimates for a preventable ADE that did not include malpractice or litigation costs, or costs of injuries to patients.
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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.