Improving Safety By Computerizing Outpatient Prescribing

Agency for Healthcare Research and Quality (AHRQ)

Status: Completed

Conditions: Impact of Electronic Prescribing on Medication Safety

Treatments: Other: Adverse Drug Event Monitoring

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT00235027

RO1 HS 11169

Details and patient eligibility

About

Patient safety is at the forefront of critical issues in health care. Medications are the single most frequent cause of adverse events, and in the inpatient setting adverse drug events (ADEs) are common, expensive, injurious to patients, and often preventable. Relatively little, however, is known about the frequency of ADEs in the ambulatory setting, how to monitor for outpatient ADEs, or on the impact of prevention strategies such as computerization of prescribing supplemented by decision-support.

Full description

Specific Aim 1: Increase routine identification of outpatient adverse drug events (ADEs) through development of a computerized ADE detection monitor.

Specific Aim 2: Use basic computerized outpatient prescribing to reduce preventable ADEs in a diverse array of outpatient settings.

Specific Aim 3: Use advanced decision-support within computerized prescribing to reduce the frequency of preventable ADEs, medication errors, and potential ADEs.

Enrollment: 701 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria: At Brigham & Women's Hospital, clinics utilizing the electronic medical record will be included. At Regenstrief, any clinic that has access to their electronic medical record will be utilized.

• For the impact of basic decision support, clinics were not randomized
• For impact of advanced decision support, clinics were randomized to receive the intervention

Exclusion Criteria:

• Clinics not using electronic medical records

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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701 participants in 2 patient groups

Adverse Drug Event Monitoring

Experimental group

Description:

In this intervention arm, clinicians received medication safety alerts when they prescribed medications in the electronic medical record.

Treatment:

Other: Adverse Drug Event Monitoring

Care as Usual

No Intervention group

Description:

In this arm, clinicians did not receive the medication safety alerts.