Evidence map›Paper›PMID 36540455›Full record

ArticleCureus2022

The Overriding of Computerized Physician Order Entry (CPOE) Drug Safety Alerts Fired by the Clinical Decision Support (CDS) Tool: Evaluation of Appropriate Responses and Alert Fatigue Solutions.

Anjum Naeem, Ali F Alwadie, Abdullah M Alshehri, Lama M Alharbi, Muhammad U Nawaz, Rawad A AlHadidi, Raed S Alshammari, Muath A Alsufyani, Lamis O Babsail, Shahad A Alshamrani and 4 more

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.6field-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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
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 4 institutions in 2 countries.

Anjum NaeemPharmaceutical Care Department, Ministry of National Guard - Health Affairs, Jeddah, SAU.
Ali F AlwadiePharmaceutical Care Department, Ministry of National Guard - Health Affairs, Jeddah, SAU.
Abdullah M AlshehriPharmaceutical Care Department, Ministry of National Guard - Health Affairs, Jeddah, SAU.
Lama M AlharbiPharmaceutical Care Department, Ministry of National Guard - Health Affairs, Jeddah, SAU.
Muhammad U NawazPharmaceutical Care Department, Ministry of National Guard - Health Affairs, Jeddah, SAU.
Rawad A AlHadidiPharmaceutical Care Department, Ministry of National Guard - Health Affairs, Jeddah, SAU.
Raed S AlshammariCollege of Pharmacy, University of Tabuk, Tabuk, SAU.
Muath A AlsufyaniCollege of Pharmacy, Umm Al-Qura University, Makkah, SAU.
Lamis O BabsailCollege of Pharmacy, Umm Al-Qura University, Makkah, SAU.
Shahad A AlshamraniCollege of Pharmacy, Umm Al-Qura University, Makkah, SAU.
Ayed A AlkatheeriDrug Information Center, Pharmacy Department, East Jeddah Hospital, Ministry of Health, Jeddah, SAU.
Norah F AlshehriClinical Pharmacy Unit, Pharmacy Department, East Jeddah Hospital, Ministry of Health, Jeddah, SAU.
Abdullah M AlzahraniPharmaceutical Care Department, Ministry of National Guard - Health Affairs, Jeddah, SAU.
Yahya A AlzahraniDrug Information Center, Pharmacy Department, East Jeddah Hospital, Ministry of Health, Jeddah, SAU.
National Guard Health Affairs · SAUniversity of Tabuk · SAAmerican Association of Colleges of Pharmacy · USUmm al-Qura University · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction Most computerized physician order entry (CPOE) software come with clinical decision-support components (CDS) that provide prescribers assistance and notify them about adverse drug reactions. An excessive number of alerts in a repeated and non-relevant manner leads to alert fatigue and enforces physicians and pharmacists to alert overrides. King Abdulaziz Medical City (KAMC) in Jeddah still reports a higher percentage of drug alerts overridden by clinicians and pharmacists. Thus, this study was conducted to evaluate CDS alerts overriding and to determine which alerts are clinically irrelevant and need modifications. Methods The study was carried out in the inpatient setting at KAMC in Jeddah, from September 1, 2020, to December 31, 2020. It was designed as a retrospective chart review study that included all red alerts that required comments and were overridden by a physician and pharmacist. Results Among 11350 red alerts, potential drug-drug interaction (pDDI), dose, and allergy alerts represent 57%, 41%, and 2%, respectively, of the total alerts. The most common drug-drug interactions (DDIs) in category X were proton pump inhibitors and clopidogrel (9.9%). The appropriate response by prescribers and pharmacists toward allergy alerts was associated with the highest odds compared with the other alerts (p < 0.05) while there is a significant decrease in the odds of appropriate action being taken by both prescribers and pharmacists in the dose screen alerts (p < 0.05). Among all clinical specialties, there is an increased odds of appropriate action being taken by residents and fellows for allergy and dose alerts, respectively, compared to other groups (p < 0.05). For diminishing the unnecessary alerts, we provided 14 alert refinements strategies and advised turning off four alerts. Applying this will terminate 32% of irrelevant alerts. Conclusion Our study's findings indicated that a substantial number of alerts are ignored, and the rate of appropriateness varies significantly by alert type and prescriber level.

Indexed as

alert fatiguealert overridingcdscpoeresponses

Identifiers

PMID36540455
PMCPMC9754301
OpenAlexW4309203352

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.