PMID- 32698231
OWN - NLM
STAT- MEDLINE
DCOM- 20210531
LR  - 20210723
IS  - 1869-0327 (Electronic)
IS  - 1869-0327 (Linking)
VI  - 11
IP  - 3
DP  - 2020 May
TI  - Clinician Perceptions of Timing and Presentation of Drug-Drug Interaction Alerts.
PG  - 487-496
LID - 10.1055/s-0040-1714276 [doi]
AB  - OBJECTIVE: Alert presentation of clinical decision support recommendations is a 
      common method for providing information; however, many alerts are overridden 
      suggesting presentation design improvements can be made. This study attempts to 
      assess pediatric prescriber information needs for drug-drug interactions (DDIs) 
      alerts and to evaluate the optimal presentation timing and presentation in the 
      medication ordering process. METHODS: Six case scenarios presented interactions 
      between medications used in pediatric specialties of general medicine, infectious 
      disease, cardiology, and neurology. Timing varied to include alert interruption 
      at medication selection versus order submission; or was noninterruptive. 
      Interviews were audiotaped, transcribed, and independently analyzed to derive 
      central themes. RESULTS: Fourteen trainee and attending clinicians trained in 
      pediatrics, cardiology, and neurology participated. Coders derived 8 central 
      themes from 929 quotes. Discordance exists between medication prescribing 
      frequency and DDI knowledge; providers may commonly prescribe medications for 
      which they do not recognize DDIs. Providers wanted alerts at medication selection 
      rather than at order signature. Alert presentation themes included standardizing 
      text, providing interaction-specific incidence/risk information, DDI rating 
      scales, consolidating alerts, and providing alternative therapies. Providers want 
      alerts to be actionable, for example, allowing medication discontinuation and 
      color visual cues for essential information. Despite alert volume, participants 
      did not "mind being reminded because there is always the chance that at that 
      particular moment (they) do not remember it" and acknowledged the importance of 
      alerts as "essential in terms of patient safety." CONCLUSION: Clinicians 
      unanimously agreed on the importance of receiving DDI alerts to improve patient 
      safety. The perceived alert value can be improved by incorporating clinician 
      preferences for timing and presentation.
CI  - Georg Thieme Verlag KG Stuttgart . New York.
FAU - Humphrey, Kate E
AU  - Humphrey KE
AD  - Patient Safety and Quality, Boston Children's Hospital, Harvard Medical School, 
      Boston, Massachusetts, United States.
FAU - Mirica, Maria
AU  - Mirica M
AD  - General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, Massachusetts, United States.
FAU - Phansalkar, Shobha
AU  - Phansalkar S
AD  - Division of General Medicine and Primary Care, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, Massachusetts, United States.
FAU - Ozonoff, Al
AU  - Ozonoff A
AD  - Precision Vaccines Program, Division of Infectious Diseases, Boston Children's 
      Hospital, Boston, Massachusetts, United States.
AD  - Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United 
      States.
FAU - Harper, Marvin B
AU  - Harper MB
AD  - Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, 
      Massachusetts, United States.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200722
PL  - Germany
TA  - Appl Clin Inform
JT  - Applied clinical informatics
JID - 101537732
SB  - IM
MH  - *Drug Interactions
MH  - Health Personnel/*psychology
MH  - Hospitals
MH  - Humans
MH  - Pediatrics
MH  - *Perception
MH  - *Reminder Systems
MH  - Surveys and Questionnaires
MH  - Time Factors
PMC - PMC7383060
COIS- None declared.
EDAT- 2020/07/23 06:00
MHDA- 2021/06/01 06:00
PMCR- 2021/07/22
CRDT- 2020/07/23 06:00
PHST- 2020/07/23 06:00 [entrez]
PHST- 2020/07/23 06:00 [pubmed]
PHST- 2021/06/01 06:00 [medline]
PHST- 2021/07/22 00:00 [pmc-release]
AID - 200018ra [pii]
AID - 10.1055/s-0040-1714276 [doi]
PST - ppublish
SO  - Appl Clin Inform. 2020 May;11(3):487-496. doi: 10.1055/s-0040-1714276. Epub 2020 
      Jul 22.