Evidence map›Paper›PMID 31427312›Full record

ArticleBMJ open2019

Optimising computerised decision support to transform medication safety and reduce prescriber burden: study protocol for a mixed-methods evaluation of drug-drug interaction alerts.

Melissa T Baysari, Wu Yi Zheng, Ling Li, Johanna Westbrook, Richard O Day, Sarah Hilmer, Bethany Annemarie Van Dort, Andrew Hargreaves, Peter Kennedy, Corey Monaghan and 4 more

Open access · goldAbstract readMulticenter StudyClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.8field-weighted citation impact, top 11% 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

10 citing papers in PubMed, 11 citations in OpenAlex.

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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

14 authors at 9 institutions in 5 countries.

Melissa T BaysariFaculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia melissa.baysari@sydney.edu.au.ORCID 0000-0003-1645-9126
Wu Yi ZhengFaculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
Ling LiCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Johanna WestbrookCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Richard O DaySt Vincent's Clinical School, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-6045-6937
Sarah HilmerKolling Institute of Medical Research and Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Bethany Annemarie Van DortFaculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-0052-6400
Andrew HargreaveseHealth NSW, Sydney, New South Wales, Australia.
Peter KennedyeHealth NSW, Sydney, New South Wales, Australia.
Corey MonaghaneHealth QLD, Queensland Department of Health, Brisbane, Queensland, Australia.
Paula DohertyJohn Hunter Hospital, Hunter New England Local Health District, Newcastle, New South Wales, Australia.
Michael DraheimMetro South Health Service District, Brisbane, Queensland, Australia.
Lucy NairBankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia.
Ruby SamsonNepean Hospital, Blue Mountains, New South Wales, Australia.
The University of Sydney · AUeHealth Africa · USMacquarie University · AUBankstown Lidcombe Hospital · AUJohn Hunter Hospital · AUMetro South Health · AUNepean Hospital · AUQueensland Health · AUSt. Vincent's Birmingham · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDrug-drug interaction (DDI) alerts in hospital electronic medication management (EMM) systems are generated at the point of prescribing to warn doctors about potential interactions in their patients' medication orders. This project aims to determine the impact of DDI alerts on DDI rates and on patient harm in the inpatient setting. It also aims to identify barriers and facilitators to optimal use of alerts, quantify the alert burden posed to prescribers with implementation of DDI alerts and to develop algorithms to improve the specificity of DDI alerting systems. METHODS AND ANALYSIS: A controlled pre-post design will be used. Study sites include six major referral hospitals in two Australian states, New South Wales and Queensland. Three hospitals will act as control sites and will implement an EMM system without DDI alerts, and three as intervention sites with DDI alerts. The medical records of 280 patients admitted in the 6 months prior to and 6 months following implementation of the EMM system at each site (total 3360 patients) will be retrospectively reviewed by study pharmacists to identify potential DDIs, clinically relevant DDIs and associated patient harm. To identify barriers and facilitators to optimal use of alerts, 10-15 doctors working at each intervention hospital will take part in observations and interviews. Non-identifiable DDI alert data will be extracted from EMM systems 6-12 months after system implementation in order to quantify alert burden on prescribers. Finally, data collected from chart review and EMM systems will be linked with clinically relevant DDIs to inform the development of algorithms to trigger only clinically relevant DDI alerts in EMM systems. ETHICS AND DISSEMINATION: This research was approved by the Hunter New England Human Research Ethics Committee (18/02/21/4.07). Study results will be published in peer-reviewed journals and presented at local and international conferences and workshops.

Indexed as

Decision Support Systems, ClinicalControlled Clinical Trials as TopicData CollectionDrug InteractionsElectronic Health RecordsFollow-Up StudiesHumansMedical Order Entry SystemsMedication Systems, HospitalNew South WalesQueenslandReminder SystemsRetrospective Studiesalertalert fatiguedecision supportdrug-drug interaction

Identifiers

PMID31427312
PMCPMC6701635
OpenAlexW2969535116

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.