The utility of adding retrospective medication profiling to computerized provider order entry in an ambulatory care population.

Glassman PA, Belperio P, Lanto A, Simon B, Valuck R, Sayers J, Lee M. The utility of adding retrospective medication profiling to computerized provider order entry in an ambulatory care population. Journal of the American Medical Informatics Association : JAMIA. 2007 Apr 25; 14(4):424-31.

Related HSR&D Project(s)

• SAF 99-144 – Patient Profiling and Provider Feedback to Reduce Adverse Drug Events

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

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 to 1 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 = 0.06; Coefficient, 0.19; 95% CI: -0.008, 0.390). 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 = 0.79). CONCLUSION: Medications safety did not improve with the addition of a medication profiling program to an electronic prescribing system.