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Computerized drug-drug interaction alerts are useful, but can be improved

Drug-drug interactions (DDIs) can seriously harm patients. For example, combining the blood-thinner warfarin with nonsteroidal anti-inflammatory drugs can lead to serious problems, such as gastrointestinal bleeding, in up to one-fourth of patients taking warfarin. Clinicians and pharmacists believe that computerized DDI alerts can improve safe drug prescribing. However, they believe that these alerts require more work to increase their clinical utility, according to a survey of 725 prescribers and 142 pharmacists from 7 Veterans Administration medical centers in the United States.

Most respondents agreed the computerized patient record system made their jobs less difficult. They did not view DDI alerts as a waste of time and 61 percent of clinicians thought that DDI alerts had increased their potential to prescribe medication safely.

Forty-four percent of clinicians were satisfied with the accuracy of the alerting system. However, they found that DDI alerts often provided them with information they already knew, and only 29 percent agreed that DDI alerts provided them with information they needed. Both clinicians and pharmacists agreed that DDI alerts should be accompanied by management alternatives (73 and 82 percent, respectively) and more detailed information (65 and 89 percent, respectively). When they were asked how they would improve DDI alerts, clinicians most preferred including management options. However, pharmacists most preferred making it more difficult to override lethal interactions.

The study was conducted by researchers at the Arizona Center for Education and Research on Therapeutics, which is supported by the Agency for Healthcare Research and Quality (HS10385).

See "Practitioners' views on computerized drug-drug interaction alerts in the VA system," by Yu Ko, M.S., Jacob Abarca, Pharm.D., M.S., Daniel C. Malone, Ph.D., and others, in the January/February 2007 Journal of the American Medical Informatics Association 14, pp. 56-64.

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