Impact of electronic prescription alerts on medication errors related to vitamin K antagonists in hospitalised patients

Abstract

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.

A comparative study of voluntarily reported medication errors among adult patients in intensive care (IC) and non- IC settings in Riyadh, Saudi Arabia

“…Based on the study results, the study site started considering strategies to reduce medication errors including the use of electronic prescription alerts. It has been suggested that the use of electronic prescription alerts may reduce medication errors [13].…”

Physicians' acceptance of drug-drug interaction alerts from clinical decision support systems: A systematic review and meta-analysis

“…Most studies selected for this systematic review were conducted in the United States (n = 4) [21,22,23,24]. The remaining studies were performed in various countries, including South Korea (n = 2) [25,26], Japan (n = 1) [27], Israel (n = 2) [28, 29], Germany (n = 1) [30], Switzerland (n = 1) [31], Belgium (n = 1) [32], Spain (n = 1) [33], Italy (n = 1) [34], Sweden (n = 1) [35], and the Kingdom of Saudi Arabia (n = 1) [36] (Table 1). All studies were conducted from 2012 to 2022; the oldest ones were carried out by Polidori et al (Italy) [34] and Fritz et al (Switzerland) [31] in 2012, and the most recent by Alsaidan et al and Tukukino et al in 2022 [35, 36].…”

“…The follow-up time of prescriptions made by physicians using a clinical physician order entry (CPOE) varied, with the shortest being just seven days [30] and the longest being 46 months [25]. As for the study design, there was one longitudinal observation study [26], ten cross-sectional studies [21,23,24,25,27,30,32,34,35,36], four prospective longitudinal studies [22,29,31,33], and one study that performed retrospective cross-sectional and prospective longitudinal studies [28] (Table 1).…”

“…Regarding the studies' research settings, two were conducted in three primary care hospitals [21,35], six studies in a tertiary care hospital [25,26,28,29,31,33], three studies in a quaternary care hospital [22,30,34], and ve studies did not report the healthcare settings [23,24,27,32,36], so we counted them as general hospitals. Among these healthcare settings, most employed commercial CDSS and drug information databases (n = 12) [21,22,23,24,28,29,30,31,32,33,34,36], and four used a system and database, at least partly, developed by the public health system [25,26,27,35] (Table 1).…”

“…Three other studies only evaluated the number of alerts for pDDIs and reported a high prevalence [29,30,33]. Amkreutz et al (2017) [30] compared two software (MediQ and Meona) and found that both showed a high prevalence of DDI alerts.…”