Evidence map›Paper›PMID 32414885›Full record

ArticleCMAJ open

Improving thiamine prescribing at an academic hospital network using the computerized provider order entry system: a cohort study.

Gregory S Day, Safiya Ladak, C Martin Del Campo

Open access · diamondAbstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 41% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Observational
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

3 authors at 2 institutions in 2 countries.

Gregory S DayDepartment of Neurology (Day), Mayo Clinic Florida, Jacksonville, Fla.; Krembil Neuroscience Centre (Ladak), University Health Network; Department of Pharmacy (Ladak, del Campo), University Health Network; Division of Neurology (del Campo), University of Toronto, Toronto, Ont. day.gregory@mayo.edu.
Safiya LadakDepartment of Neurology (Day), Mayo Clinic Florida, Jacksonville, Fla.; Krembil Neuroscience Centre (Ladak), University Health Network; Department of Pharmacy (Ladak, del Campo), University Health Network; Division of Neurology (del Campo), University of Toronto, Toronto, Ont.
C Martin Del CampoDepartment of Neurology (Day), Mayo Clinic Florida, Jacksonville, Fla.; Krembil Neuroscience Centre (Ladak), University Health Network; Department of Pharmacy (Ladak, del Campo), University Health Network; Division of Neurology (del Campo), University of Toronto, Toronto, Ont.
University Health Network · CAHealth Net · US

Funding

Rapidly Progressive Dementia: Moving Beyond CJDK23AG064029 · NIA · WASHINGTON UNIVERSITY · PI DAY, GREGORY SCOTT · 2019 to 2023
$811k
NIA NIH HHS K23 AG064029
6 · The paper itself

Abstract

backgroundOral thiamine therapy is frequently prescribed to patients at risk for thiamine deficiency despite recommendations emphasizing the need for high doses of parenteral thiamine to reverse brain thiamine deficits. We evaluated the effect of changes to the computerized provider order entry system on the proportion of prescriptions for parenteral thiamine treatment (primary outcome) and dosages prescribed (secondary outcome) within our academic hospital network.

methodsWe obtained data from the pharmacy information system recording thiamine prescribed to inpatients at University Health Network hospitals (Toronto, Ontario) before (Jan. 1, 2010, to Dec. 31, 2011) and after (Nov. 21, 2013, to Apr. 30, 2017) changes to the computerized provider order entry system promoting the use of higher dosages (≥ 200 mg) of parenterally administered thiamine. Patients receiving thiamine as part of total parenteral nutrition were excluded from analyses, as thiamine prescribing was automated and unlikely to be affected by the intervention.

resultsA total of 6105 thiamine prescriptions were written for 2907 patients before the intervention and 12 787 thiamine prescriptions for 8032 patients after the intervention. The proportion of prescriptions for parenteral treatment increased from 55.5% (3386/6105) to 92.5% (11 829/12 787) after the intervention (

interpretationChanges to the computerized provider order entry system were associated with sustained increases in the proportion of prescriptions for high-dose parenteral thiamine therapy. Similar approaches may be leveraged to align prescriber behaviour with well-accepted practice parameters in other areas of medicine.

Indexed as

Hospitals, UniversityMedical Order Entry SystemsQuality ImprovementThiamineCohort StudiesDrug PrescriptionsFemaleHumansMaleOntarioPublic Health SurveillanceQuality Assurance, Health CareThiamine DeficiencyThiamine

Identifiers

PMID32414885
PMCPMC7239638
OpenAlexW3024473675

What OpenQuestion holds

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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.