ArticleJournal of the American Medical Informatics Association : JAMIA2019
Structured override reasons for drug-drug interaction alerts in electronic health records.
Article in Journal of the American Medical Informatics Association : JAMIA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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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.
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Who cites it
22 citing papers in PubMed.
- User Actions within a Clinical Decision Support Alert for the Management of Hypertension in Chronic Kidney Disease.Applied clinical informatics · 2025Trial
- Evaluation of Diagnostic Recommendations Embedded in Medication Alerts: Prospective Single-Arm Interventional Study.Journal of medical Internet research · 2025Article
- Allergy alerting and overrides for opioid analogues across two health systems.BMJ health & care informatics · 2025Observational
- Interprofessional Evaluation of a Medication Clinical Decision Support System Prior to Implementation.Applied clinical informatics · 2024Article
- Factors Influencing Health Care Professionals' Perceptions of Frequent Drug-Drug Interaction Alerts.ACI open · 2024Article
- An Evaluation of Drug-Drug Interaction Alerts Produced by Clinical Decision Support Systems in a Tertiary Hospital.Cureus · 2023Article
- An Ontology-Based Approach to Improving Medication Appropriateness in Older Patients: Algorithm Development and Validation Study.JMIR medical informatics · 2023Article
- Use of electronic health record best practice alerts to improve adherence to American Urological Association vesicoureteral reflux guidelines.Pediatric surgery international · 2022Article
- Managing Critical Patient-Reported Outcome Measures in Oncology Settings: System Development and Retrospective Study.JMIR medical informatics · 2022Article
- Appropriateness of Alerts and Physicians' Responses With a Medication-Related Clinical Decision Support System: Retrospective Observational Study.JMIR medical informatics · 2022Article
- OntoPharma: ontology based clinical decision support system to reduce medication prescribing errors.BMC medical informatics and decision making · 2022Article
- Human-centered design of clinical decision support for management of hypertension with chronic kidney disease.BMC medical informatics and decision making · 2022Article
- Contextualized Drug-Drug Interaction Management Improves Clinical Utility Compared With Basic Drug-Drug Interaction Management in Hospitalized Patients.Clinical pharmacology and therapeutics · 2022Article
- Improving the specificity of drug-drug interaction alerts: Can it be done?American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2022Article
- Potential Drug Interactions Between Psychotropics and Intravenous Chemotherapeutics Used by Patients With Cancer.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2022Article
- Overall performance of a drug-drug interaction clinical decision support system: quantitative evaluation and end-user survey.BMC medical informatics and decision making · 2022Article
- Racial Disparity in Clinical Alert Overrides.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2021Article
- Article
- Appropriateness of Overridden Alerts in Computerized Physician Order Entry: Systematic Review.JMIR medical informatics · 2020Review
- Reducing Alert Burden in Electronic Health Records: State of the Art Recommendations from Four Health Systems.Applied clinical informatics · 2020Article
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
objectiveThe study sought to determine availability and use of structured override reasons for drug-drug interaction (DDI) alerts in electronic health records. MATERIALS AND
methodsWe collected data on DDI alerts and override reasons from 10 clinical sites across the United States using a variety of electronic health records. We used a multistage iterative card sort method to categorize the override reasons from all sites and identified best practices.
resultsOur methodology established 177 unique override reasons across the 10 sites. The number of coded override reasons at each site ranged from 3 to 100. Many sites offered override reasons not relevant to DDIs. Twelve categories of override reasons were identified. Three categories accounted for 78% of all overrides: "will monitor or take precautions," "not clinically significant," and "benefit outweighs risk." DISCUSSION: We found wide variability in override reasons between sites and many opportunities to improve alerts. Some override reasons were irrelevant to DDIs. Many override reasons attested to a future action (eg, decreasing a dose or ordering monitoring tests), which requires an additional step after the alert is overridden, unless the alert is made actionable. Some override reasons deferred to another party, although override reasons often are not visible to other users. Many override reasons stated that the alert was inaccurate, suggesting that specificity of alerts could be improved.
conclusionsOrganizations should improve the options available to providers who choose to override DDI alerts. DDI alerting systems should be actionable and alerts should be tailored to the patient and drug pairs.
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Registered trials
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