Most medication warnings generated by hospital computerized provider order entry (CPOE) systems are overridden or ignored by clinicians, according to research presented at the annual meeting of the Society of Hospital Medicine.
For the study, researchers examined data from a 410-bed medical center with a CPOE system that uses data on drug interactions to generate warnings if a medication order creates a risk of allergic reactions, adverse events, interactions, or duplications.
Overall, the researchers found that clinicians accepted only 4% of the 40,391 drug warning alerts issued during the one-year study period. They also found that:
- 47% of the alerts involved potential drug duplications;
- 47% involved potential drug interactions;
- 6% involved potential allergic reactions; and
- 0.1% involved potential adverse reactions.
Amy Knight—assistant professor of medicine at Johns Hopkins Bayview Medical Center and lead author of the study—says, "The least common warnings were those that were most frequently accepted, with the average accepted warnings for drug interactions and allergy being 37% and 10%, respectively."
According to Knight, clinicians using CPOE systems often "develop 'alert fatigue' and end up overriding many potentially important warnings." She recommends that CPOE system developers restructure medication alert programs "to more clearly differentiate between types of warnings and, in particular, to distinguish the warnings that are most likely to have severe consequences" (Walsh, MedPage Today, 4/6).