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The use of CPOE minimises the occurrence of medication errors, however, they still occur. Most errors are associated with the CPOE technology. We therefore face a new challenge in the prevention of ME that require a change in strategy for patient safety. Continued training of prescribers, standardization of the electronic prescription programs and integration between computer applications in hospitals and with primary care should be a priority.

Implementation of CPOE programs for pediatrics, communication improvement between healthcare professionals taking care of admitted children and the knowledge of these programs should be the mayor priorities for the safety of hospitalized children.

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Anticoagulants are widely used in patients with pulmonary arterial hypertension (PAH) to prolong survival. However, there is a lack of robust evidence demonstrating the benefits of anticoagulants in PAH patients and very little is known about the complications of their use in this population. The objective of this study is to compare the safety of routine administration of oral anticoagulants between PAH patients who were and were not treated with oral anticoagulants. This observational, retrospective cohort study included consecutive patients with confirmed PAH from two centers: Brigham and Women’s Hospital in Boston and Hospital Universitario La Paz in Madrid from January 2009 to August 2015. The study group comprised patients who received therapeutic anticoagulation; patients who had never received anticoagulants were placed in the control group. Of the 201 included patients, 60.2% were treated with oral anticoagulants and 39.8% were not treated. The hazard ratio for major bleeding was 2.7 (95% confidence interval [CI] = 1.1–6.8; P = 0.036). The incidence rate for the anticoagulation group was 4.7 per 100 patient-years (95% CI = 2.5–8.0). The most frequent major hemorrhage was gastrointestinal bleeding with 24 cases (72.7%). Prior bleeding, poor anticoagulation, HAS-BLED score ≥3, diabetes, and number of medications were factors that increased the risk of major bleeding in patients using anticoagulants. The harmful effects of anticoagulants could outweigh the benefits in PAH patients. Therefore, anticoagulants should be prescribed on a case-by-case basis and should not be systematically recommended.

In hospitalized patients there is a high prevalence of prescription of proton-pump-inhibitors unnecessarily. The superfluous use is often associated with the prescription of treatment protocols. Those treatments started in the hospital generally did not contribute to over-use existing primary care, most of them were removed at discharge.

Objectives To analyse the impact of the computerised prescription order entry (CPOE) alerts on the reduction of errors due to medication interactions in the prescribing process of vitamin K antagonists. Methods Prospective study over 3 months in a 1400-bed university tertiary care centre gifted with CPOE software, which includes medication interaction alerts. Adult patients receiving oral anticoagulant treatment with vitamin K antagonists with international normalised ratio ≥4 were included. The reason for their hyperanticoagulation was evaluated. We analysed the impact of incorporating interactive alerts in the prescription of vitamin K antagonists in terms of reduction of medication errors by comparing results with a previous period with no interaction alerts incorporated in the software. The main outcome measure was medication errors. Results Implementation of alerts reduced the number of medication errors caused by drug interactions by 71.4% (p=0.02). The number of errors diminished from 10.5 per month to 3 when interaction alerts were introduced. Conclusions Implementation of a CPOE interaction alert programme reduces interaction errors. Additionally, the use of this new technology allowed us to perform a thorough analysis of data and to identify and implement actions aimed at improving patient safety.

New technologies like computerized physician order entry systems, that includes a support alert for drug allergies, can be an effective tool to prevent medical errors related to drug hypersensitivity most of them caused by lack of documentation and information.