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A mixed method study of the merits of e-prescribing drug alerts in primary care

机译:关于初级保健中电子处方药警报优劣的混合方法研究

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摘要

OBJECTIVES: The objective of this paper was to describe primary care prescribers\u27 perspectives on electronic prescribing drug alerts at the point of prescribing.DESIGN: We used a mixed-method study which included clinician surveys (web-based and paper) and focus groups with prescribers and staff.PARTICIPANTS: Prescribers (n = 157) working in one of 64 practices using 1 of 6 e-prescribing technologies in 6 US states completed the quantitative survey and 276 prescribers and staff participated in focus groups.MEASUREMENTS: The study measures self-reported frequency of overriding of drug alerts; open-ended responses to: \u22What do you think of the drug alerts your software generates for you?\u22RESULTS: More than 40% of prescribers indicated they override drug-drug interactions most of the time or always (range by e-prescribing system, 25% to 50%). Participants indicated that the software and the interaction alerts were beneficial to patient safety and valued seeing drug-drug interactions for medications prescribed by others. However, they noted that alerts are too sensitive and often unnecessary. Participant suggestions included: (1) run drug alerts on an active medication list and (2) allow prescribers to set the threshold for severity of alerts.CONCLUSIONS: Primary care prescribers recognize the patient safety value of drug prescribing alerts embedded within electronic prescribing software. Improvements to increase specificity and reduce alert overload are needed.
机译:目的:本文的目的是在处方时描述基层医疗开处方者对电子处方药警报的观点。设计:我们使用了混合方法研究,其中包括临床医生调查(基于网络和论文)和焦点小组研究对象:处方药(n = 157)使用美国6个州的6种电子处方技术中的1种在64种实践中的一种工作,完成了定量调查,有276名处方药和职员参加了焦点小组。自我报告的覆写毒品警告的频率;开放式响应:\ u22您如何看待软件为您生成的药物警报?\ u22结果:超过40%的处方者表示,他们大部分时间或始终忽略药物与药物的相互作用(由电子处方系统决定) ,从25%到50%)。与会人员表示,该软件和交互警报对患者安全有益,并非常重视看到他人处方的药物相互作用。但是,他们指出,警报过于敏感,通常是不必要的。参与者的建议包括:(1)在有效药物清单上运行药物警报,以及(2)允许处方者设置警报严重性的阈值。结论:初级保健处方者认识到电子处方软件中嵌入的药物处方警报对患者的安全价值。需要改进以增加特异性并减少警报过载。

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