ArticleJournal of the American Medical Informatics Association : JAMIA2020
High-priority drug-drug interaction clinical decision support overrides in a newly implemented commercial computerized provider order-entry system: Override appropriateness and adverse drug events.
Article in Journal of the American Medical Informatics Association : JAMIA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed.
- Polypharmacy, Potential Drug-Drug Interactions and Medication Non-Adherence in Patients with Multiple Sclerosis: A Longitudinal Study.Neurology and therapy · 2026Article
- Qualitative Study of Inpatient Hospital Medicine Interruptive Alerts and Clinical Decision Support.Applied clinical informatics · 2026Article
- Verification of the value of optimization of the medication-related clinical decision support system in China, a hospital-based study.JAMIA open · 2026Article
- Impact of an Interruptive Alert on the Number of Women Receiving CDC-Recommended Therapy for Trichomoniasis.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2026Article
- Prevalence and clinical significance of potential drug-drug interactions of antimicrobials in Intensive Care Unit patients: a retrospective study.BMC pharmacology & toxicology · 2025Article
- Barriers and Enablers to Using a Mobile App-Based Clinical Decision Support System in Managing Perioperative Adverse Events Among Anesthesia Providers: Cross-Sectional Survey in China.Journal of medical Internet research · 2025Article
- Challenges to Reduce Alert Burden Using Current Decision Support Infrastructure in Two Commercial EHR Systems: Lessons Learned and Path Forward.Applied clinical informatics · 2025Article
- Facilitators and Barriers to Uptake of Drug-Drug Interaction Alerts: Perspectives of Australian End Users and Managers.Applied clinical informatics · 2025Article
- Characterization of children's prospective prescription review and exploration of factors influencing the success of interventions.Therapeutic advances in drug safety · 2025Article
- A comparison of five different drug-drug interaction checkers for selective serotonin reuptake inhibitors.Frontiers in pharmacology · 2025Article
- Effects of a Revision to the Standard Admission Order Set on Laxative Prescribing for Opioid-Induced Constipation.Journal of the advanced practitioner in oncology · 2024Article
- The Impact of Customized Screening Intervals on the Burden of Drug-Drug Interaction Alerts: An Interrupted Time Series Analysis.Journal of medical systems · 2024Article
- Agreement of Different Drug-Drug Interaction Checkers for Proton Pump Inhibitors.JAMA network open · 2024Article
- An Evaluation of Drug-Drug Interaction Alerts Produced by Clinical Decision Support Systems in a Tertiary Hospital.Cureus · 2023Article
- Barriers to Adoption of Tailored Drug-Drug Interaction Clinical Decision Support.Applied clinical informatics · 2023Article
- Managing Critical Patient-Reported Outcome Measures in Oncology Settings: System Development and Retrospective Study.JMIR medical informatics · 2022Article
- Co-prescription of metoprolol and CYP2D6-inhibiting antidepressants before and after implementation of an optimized drug interaction database in Norway.European journal of clinical pharmacology · 2022Article
- Potential Drug-Drug Interactions in a Cardiac Center: Development of Simple Software for Pattern Identification.The journal of Tehran Heart Center · 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
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe study sought to determine frequency and appropriateness of overrides of high-priority drug-drug interaction (DDI) alerts and whether adverse drug events (ADEs) were associated with overrides in a newly implemented electronic health record. MATERIALS AND
methodsWe conducted a retrospective study of overridden high-priority DDI alerts occurring from April 1, 2016, to March 31, 2017, from inpatient and outpatient settings at an academic health center. We studied highest-severity DDIs that were previously designated as "hard stops" and additional high-priority DDIs identified from clinical experience and literature review. All highest-severity alert overrides (n = 193) plus a stratified random sample of additional overrides (n = 371) were evaluated for override appropriateness, using predetermined criteria. Charts were reviewed to identify ADEs for overrides that resulted in medication administration. A chi-square test was used to compare ADE rate by override appropriateness.
resultsOf 16 011 alerts presented to providers, 15 318 (95.7%) were overridden, including 193 (87.3%) of the highest-severity DDIs and 15 125 (95.8%) of additional DDIs. Override appropriateness was 45.4% overall, 0.5% for highest-severity DDIs and 68.7% for additional DDIs. For alerts that resulted in medication administration (n = 423, 75.0%), 29 ADEs were identified (6.9%, 5.1 per 100 overrides). The rate of ADEs was higher with inappropriate vs appropriate overrides (9.4% vs 4.3%; P = .038).
conclusionsThe override rate was nearly 90% for even the highest-severity DDI alerts, indicating that stronger suggestions should be made for these alerts, while other alerts should be evaluated for potential suppression.
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