Can the Use of Computer Decision Support System Prevent Complicated Ulcer among Patients Treated with NSAID or Aspirin? A Randomised Controlled Trial in General Practice

Petersen, Jóhanna; Jarbøl, Dorte Ejg; Hallas, Jesper; Storsveen, Maria Munch; Muckadell, Ove B. Schaffalitzky de; Moeller, Jane

doi:10.1016/s0016-5085(17)31039-9

Cited by 5 publications

(13 citation statements)

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“…The results of this study are consistent with the findings of Nicastro reporting the positive effects of the system on the behavior of physicians such as adherence to clinical guidelines and prescription of drugs [66]. The reason for the positive effect of CDSS on the prescribing of nonsteroidal anti-inflammatory drugs and proton pump inhibitors in healthy and high-risk patients and the use of oral rehydration solution was the systems' recommendations relating to the abovementioned drugs and their previous knowledge [28][29][30].…”

Section: Discussionsupporting

confidence: 89%

“…The results of this study indicate that the use of CDSS in diabetic patients has a positive effect on a The results of this study show that the use of CDSS in digestive disorders has a positive effect on the physicians' performance in a number of outcomes such as the standard use of oral rehydration solution, the prescription of non-steroidal anti-inflammatory drugs and proton pump inhibitors in normal and high-risk patients, and the provision of care services in line with the guidelines for primary care [28][29][30]. The results of this study are consistent with the findings of Nicastro reporting the positive effects of the system on the behavior of physicians such as adherence to clinical guidelines and prescription of drugs [66].…”

Section: Discussionmentioning

confidence: 84%

“…In all studies, the CDSS had an effect on prescribing non-steroidal anti-inflammatory drugs, proton pump inhibitors, and increasing the standard use of oral rehydration solution without any difference in other results [28][29][30]. The alert based CDSS was able to improve the quality of patient care to some degree in the other study [29].…”

Section: The Effect Of Cdss On Digestive Diseasesmentioning

confidence: 84%

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The effects of clinical decision support system for prescribing on patient outcomes and physician practice performance: A systematic review

Moghadam¹,

Velayati²,

Sadoughi³

et al. 2020

Preprint

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Background The clinical decision support systems(CDSSs) for prescription medications is one of the technologies aimed at improving physician practice behavior and patient outcomes by reducing drug prescription errors. This study was conducted to investigate the effect of various CDSSs on physician practice behavior and patient outcomes.Methods This systematic review was conducted by searching in PubMed, EMBASE, Web of Science, Scopus and Cochrane Library from January 2005 to November 2019. Two researchers independently evaluated the studies. Any discrepancies over the eligibility of the studies between the two researchers were then resolved by consulting a third researcher. Finally, data were extracted from the articles; however, we could not able to conduct meta-analysis due to the heterogeneity of the studies and the narrative form of the findings.Results Based on the inclusion criteria, 46 studies were considered eligible for the analysis in this review. The CDSS for prescription medications had been used for various diseases, namely cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, mental disease. Meanwhile, other cases such as the concurrent prescription of multiple drugs for the patient and its effects on the above-mentioned outcomes were evaluated. The analysis shows that in some cases the application of CDSS provides positive effects on patient outcomes and physician practice behaviors. No significant difference was observed in comparison between some other cases and conventional methods. We think that this could be due to the disease type, the quantity and type of CDSS requirements that influence the comparison.Conclusions Our findings suggest that the positive effects of the CDSS are due to factors such as user-friendliness, compliance with clinical guidelines, patient and doctor cooperation, integration of electronic health records, CDSS and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts and their real-time alerts in the prescription.Registration number on PROSPERO CRD42018079936.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 84%

Section: The Effect Of Cdss On Digestive Diseasesmentioning

confidence: 84%

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The effects of clinical decision support system for prescribing on patient outcomes and physician practice performance: A systematic review

Moghadam¹,

Velayati²,

Sadoughi³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Also, the results of this study show that the use of CDSS in digestive disorders has a positive effect on the physician performance in a variety of outcomes such as the standard use of oral rehydration solution, the prescription of non-steroidal anti-in ammatory drugs and proton pump inhibitors in normal and highrisk patients, and the provision of care services in line with the guidelines for primary care [32][33][34]. The results of this study are also consistent with the ndings of Nicastro, reporting the positive effects of the system on the behavior of physicians such as adherence to clinical guidelines and prescription of drugs [72].…”

Section: Discussionmentioning

confidence: 80%

“…In all studies, the CDSS had an effect on prescribing non-steroidal anti-in ammatory drugs, proton pump inhibitors, and increasing the standard use of oral rehydration solution without any difference in other results [32][33][34]. The alert-based CDSS was also able to improve the quality of patient care to some degree in the other study [33].…”

Section: The Effect Of Cdss On Cardiovascular Diseasesmentioning

confidence: 84%

The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: A systematic review and meta-analysis

Moghadam

Velayati

Sadoughi

et al. 2020

Preprint

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Background: The clinical decision support systems (CDSSs) for prescription medications is one of the technologies aimed at improving physician practice behavior and patient outcomes by reducing drug prescription errors. This study, thus, was conducted to investigate the effect of various CDSSs on physician practice behavior and patient outcomes.Methods: This systematic review was conducted by searching in PubMed, EMBASE, Web of Science, Scopus and Cochrane Library from 2005 to 2019. Two researchers independently evaluated the studies. Any discrepancies over the eligibility of the studies between the two researchers were then resolved by consulting a third researcher. Finally, we extracted data from the articles. Then, we conducted a meta-analysis based on medication subgroups and outcome categories; we also presented a narrative form of the findings. Meanwhile, we applied random-effects model to estimate the effects of CDSS on patient outcomes and physician practice performance with 95% confidence interval. Q statistics and I2 was then used to measure heterogeneity.Results: Based on the inclusion criteria, 46 studies were considered eligible for the analysis in this review. The CDSS for prescription medications had been used for various diseases such as cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, and mental disease. Meanwhile, other cases such as the concurrent prescription of multiple drugs for patients and its effects on the above-mentioned outcomes were evaluated. The analysis shows that in some cases the application of CDSS provides positive effects on patient outcomes and physician practice behaviors. The effect was statistically significant (std diff in means =0.114, 95% CI: 0.090 to 0.138) as overall. It was also statistically significant for outcome groups such as those showing improved outcomes on physician practice performance and patient outcome or both. No significant difference was observed in comparison between some other cases and conventional methods. We think that this could be due to the disease type, the quantity, and the type of CDSS requirements that influenced the comparison. Conclusions: Our findings suggest that positive effects of the CDSS are due to factors such as user-friendliness, compliance with clinical guidelines, patient and doctor cooperation, integration of electronic health records, CDSS and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts, and their real-time alerts in the prescription.

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Impact of pharmacist-evaluated clinical decision support system alerts on potentially missing or inappropriately prescribed proton pump inhibitors at hospital discharge: a retrospective cross-sectional study

Flückiger,

Zaugg,

Fiumefreddo

2024

Int J Clin Pharm

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Background Proton pump inhibitors (PPIs) are among the most prescribed drugs. A clinical decision support system (CDSS) could improve their rational use. Aim The impact of an electronic algorithm (e-algorithm) implemented in a CDSS on potentially missing or inappropriately prescribed PPIs at hospital discharge, its specificity and sensitivity, and the outcome of the alerts issued were analysed. Method An e-algorithm continuously monitored patients of a tertiary care hospital for missing or inappropriate PPIs. Following relevance assessment by a pharmacist, the alerts raised were either displayed in the patients’ electronic record or dismissed. After a three-month period, all adult patients’ records were retrospectively reviewed for missing or inappropriate PPIs at discharge. The results were compared with a corresponding period before CDSS introduction. Sensitivity, specificity and outcome of alerts were quantified. Results In a 3-month period with 5018 patients, the CDSS created 158 alerts for missing PPIs and 464 alerts for inappropriate PPIs. PPI prescribing was proposed 81 times and PPI termination 122 times, with acceptance rates of 73% and 34%, respectively. A specificity of 99.4% and sensitivity of 92.0% for missing PPIs and a specificity of 97.1% and a sensitivity of 69.7% for inappropriate PPIs were calculated. The algorithm reduced incidents of missing PPIs by 63.4% (p < 0.001) and of inappropriate PPIs by 16.2% (p = 0.022). Conclusion The algorithm identified patients without necessary gastroprotection or inappropriate PPIs with high specificity and acceptable sensitivity. It positively impacted the rational use of PPIs by reducing incidents of missing and inappropriate PPIs.

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Can the Use of Computer Decision Support System Prevent Complicated Ulcer among Patients Treated with NSAID or Aspirin? A Randomised Controlled Trial in General Practice

Cited by 5 publications

References 0 publications

The effects of clinical decision support system for prescribing on patient outcomes and physician practice performance: A systematic review

The effects of clinical decision support system for prescribing on patient outcomes and physician practice performance: A systematic review

The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: A systematic review and meta-analysis

Impact of pharmacist-evaluated clinical decision support system alerts on potentially missing or inappropriately prescribed proton pump inhibitors at hospital discharge: a retrospective cross-sectional study

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