331 e-Prescribing Alerts to Prevent 1 Adverse Drug Event

In this study, physicians overrode 91% of the medication alerts.  This same problem occurs with pharmacy computer systems.  The article provides some ideas for improving these results such as carefully selecting the alerts most likely to result in meaningful improvements.  However, this highlights why we should not rely on e-prescribing systems alone to minimize the risk of medication related problems.  Not only do these systems have limited effectiveness they also do not reduce the risks that occur once the patient has the prescription, particularly non-adherence.

Study: Doctors Ignoring e-Prescribing Warning Systems

via Daily Advantage from Pharmalive.com

"A new study said that doctors are more often overriding the automating warning systems of e-prescribing tools because they prefer to rely on their own judgment and find the alerts annoying. According to the study, clinicians overrode more than 90 percent of the drug interaction alerts and 77 percent of the drug allergy alerts. "The sheer volume of alerts generated by electronic prescribing systems stands to limit the safety benefits," said one of the study's authors."

The same problem occurs with PBM alerts generated at the pharmacy during claim submission. In addition to being slower than just writing the script on a prescription pad, this "steals" time from the physicians without improving quality. This adds one more reason why less than 20% of physicians use e-prescribing even occasionally.

Until the vendors figure out how to minimize this "white noise" and increase focus on pertinent alerts we will need other systems to help minimize drug therapy problems. Sophisticated alert identification and notification systems can combine medical and pharmacy claims to provide highly targeted, pertinent and actionable alerts to physicians, pharmacists and other care managers.