help button home button JAMIA Hate scrolling?
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
First published April 25, 2007 as JAMIA PrePrint; doi:10.1197/jamia.M2313
Journal of the American Medical Informatics Association 2007;14(4):424-431
© 2007 American Medical Informatics Association

A more recent version of this article appeared on July 1, 2007
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
M2313v1
14/4/424    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Glassman, P. A.
Right arrow Articles by Lee, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Glassman, P. A.
Right arrow Articles by Lee, M.

Submitted on October 25, 2006
Accepted on April 2, 2007

The Utility of Adding Retrospective Medication Profiling to Computerized Provider Order Entry in an Ambulatory Care Population

Peter A. Glassman MBBS, MSc1*, Pamela Belperio PharmD2, Andrew Lanto MA3, Barbara Simon MA3, Robert Valuck PhD, RPh4, Jeffrey Sayers PharmD5, and Martin Lee PhD3

Affiliation of the authors: 1 VA Greater Los Angeles Healthcare System VA HSR&D Center of Excellence for the Study of Healthcare Provider Behavior, Loa Angeles, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; VA Center for Medication Safety, Hines, IL ; 2 VA Public Health Strategic Healthcare Group, Los Angeles, CA; VA Palo Alto Healthcare System, Los Angeles, CA; VA HSR&D Center of Excellence for the Study of Healthcare Provider Behavior, Los Angeles, CA; VA Greater Los Angeles Healthcare System – West Los Angeles, Los Angeles, CA ; 3 VA HSR&D Center of Excellence for the Study of Healthcare Provider Behavior, Los Angeles, CA; VA Greater Los Angeles Healthcare System – Sepulveda, Los Angeles, CA ; 4 Department of Clinical Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO ; 5 VA Greater Los Angeles Healthcare System, Los Angeles, CA

* To whom correspondence should be addressed.

Background We assessed whether medication safety improved when a medication profiling program was added to a computerized provider order entry system.

Design Between June 2001 and January 2002 we profiled outpatients with potential prescribing errors using computerized retrospective drug utilization software. We focused primarily on drug interactions. Patients were randomly assigned either to Provider Feedback or to Usual Care. Subsequent adverse drug event (ADE) incidence and other outcomes, including ADE preventability and severity, occurring up to1 year following the last profiling date were evaluated retrospectively by a pharmacist blinded to patient assignment.

Measurements Data were abstracted using a study-designed instrument. An ADE was defined by an Adverse Drug Reaction Probability scale score of 1 or more. Statistical analyses included negative binomial regression for comparing ADE incidence.

Results Of 913 patients in the analytic sample, 371 patients (41%) had one or more ADEs. Incidence, by individual, was not significantly different between Usual Care and Provider Feedback groups (37% vs. 45%; P = .06; Coefficient, 0.19; 95% CI: -.008, .390). ADE severity was also similar. For example, 51% of ADEs in the Usual Care and 58% in the Provider Feedback groups involved symptoms that were not serious (95% CI for the difference, -15%, 2%). Finally, ADE preventability did not differ. For example, 16% in the Usual Care group and 17% in the Provider Feedback group had an associated warning (95% CI for the difference, -7 to 5%; P = .79).

Conclusions Medications safety did not improve with the addition of a medication profiling program to an electronic prescribing system.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 1994 by the American Medical Informatics Association.