Macquarie University
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Enabling drug-drug interaction alerts in an electronic medication management system: impact on prescriber alert burden

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posted on 2022-03-29, 02:18 authored by Anmol Preet Kaur Sandhu
The volume of clinical decision support (CDS) alerts encountered by prescribers (i.e. alert burden) within electronic medication management (EMM) systems is likely to influence whether CDS alerts are read and acted upon. This study aimed to determine the impact of introducing drug-drug interaction (DDI) alerts on the total alert burden experienced by prescribers. This was a simulated cohort study. Clinical data for a given study date were extracted from a ‘live’ EMM system in use at a tertiary teaching hospital. No DDI alerts were enabled in the hospital at the time (Alert Condition 1). The same medication orders were then replicated via manual entry into a simulated version of the EMM system where DDI alerts were enabled (Alert Condition 2). CDS alert data from Alert Condition 1 and 2 were extracted and compared. With DDI alerts in place, prescriber alert burden increased from 38% to 72% of a prescriber’s medication orders triggering at least one alert. Alerts were encountered by almost all doctors (91%), and each doctor received approximately four times more alerts (15 alerts vs 3.8 alerts per doctor) than in the absence of DDI alerts. DDI alerts, if enabled, would significantly increase the alert burden on prescribers and are likely to lead to alert fatigue. To reduce their impact on prescriber alert burden and improve alert effectiveness, DDI alerts should be refined prior to their implementation.


Table of Contents

1. Introduction -- 2. Method -- 3. Results -- 4. Discussion -- 5. Conclusion -- 6. Appendix -- 7. References.


Empirical thesis. Bibliography: pages 39-46

Awarding Institution

Macquarie University

Degree Type

Thesis MRes


MRes, Macquarie University, Faculty of Medicine and Health Sciences, Australian Institute of Health Innovation

Department, Centre or School

Australian Institute of Health Innovation

Year of Award


Principal Supervisor

Melissa Baysari

Additional Supervisor 1

Johanna I. M. (Johanna Irene Mary) Westbrook


Copyright Anmol Preet Kaur Sandhu 2019. Copyright disclaimer:




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