TY - JOUR
KW - Adverse Drug Reaction Reporting Systems/utilization
KW - Clinical Alarms/utilization
KW - Clinical Decision-Making
KW - Decision Support Systems, Clinical/utilization
KW - Drug Hypersensitivity/epidemiology/prevention & control
KW - Humans
KW - Incidence
KW - Medical Order Entry Systems/utilization
KW - Medication Errors/prevention & control/statistics & numerical data
KW - Opioid-Related Disorders/epidemiology/prevention & control
KW - Risk Factors
KW - United States/epidemiology
KW - User-Computer Interface
KW - Utilization Review
AU - M. Topaz
AU - D. L. Seger
AU - K. Lai
AU - P. G. Wickner
AU - F. Goss
AU - N. Dhopeshwarkar
AU - F. Chang
AU - D. W. Bates
AU - L. Zhou
A1 - 
AB - This study examined trends in drug-allergy interaction (DAI) alert overrides for opioid medications - the most commonly triggered alerts in the computerized provider order entry (CPOE). We conducted an observational analysis of the DAI opioid alerts triggered over the last decade (2004-2013, n=342,338) in two large academic hospitals in Boston (United States). We found an increasing rate of DAI alert overrides culminating in 89.7% in 2013. Allergic reactions included a high proportion (38.2%) of non-immune mediated opioid reactions (e.g. gastrointestinal upset). The DAI alert override rate was high for immune mediated (88.6%) and life threatening reactions (87.8%). Exact allergy-medication matches were overridden less frequently (about 70%) compared to non-exact matches within allergy groups (over 90%). About one-third of the alert override reasons pointed to irrelevant alerts (i.e."Patient has tolerated the medication before") and 44.9% were unknown. Those findings warrant further investigation into providers' reasons for high override rate. User interfaces should evolve to enable less interruptive and more accurate alerts to decrease alert fatigue.
BT - Studies in health technology and informatics
C5 - Opioids & Substance Use; HIT & Telehealth
CY - Netherlands
JF - Studies in health technology and informatics
N2 - This study examined trends in drug-allergy interaction (DAI) alert overrides for opioid medications - the most commonly triggered alerts in the computerized provider order entry (CPOE). We conducted an observational analysis of the DAI opioid alerts triggered over the last decade (2004-2013, n=342,338) in two large academic hospitals in Boston (United States). We found an increasing rate of DAI alert overrides culminating in 89.7% in 2013. Allergic reactions included a high proportion (38.2%) of non-immune mediated opioid reactions (e.g. gastrointestinal upset). The DAI alert override rate was high for immune mediated (88.6%) and life threatening reactions (87.8%). Exact allergy-medication matches were overridden less frequently (about 70%) compared to non-exact matches within allergy groups (over 90%). About one-third of the alert override reasons pointed to irrelevant alerts (i.e."Patient has tolerated the medication before") and 44.9% were unknown. Those findings warrant further investigation into providers' reasons for high override rate. User interfaces should evolve to enable less interruptive and more accurate alerts to decrease alert fatigue.
PP - Netherlands
PY - 2015
SN - 0926-9630; 0926-9630
SP - 242
EP - 246
EP - 
T1 - High Override Rate for Opioid Drug-allergy Interaction Alerts: Current Trends and Recommendations for Future
T2 - Studies in health technology and informatics
TI - High Override Rate for Opioid Drug-allergy Interaction Alerts: Current Trends and Recommendations for Future
U1 - Opioids & Substance Use; HIT & Telehealth
U2 - 26262047
VL - 216
VO - 0926-9630; 0926-9630
Y1 - 2015
ER -