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Published on: February 13, 2020
The role of pharmacy computer systems in preventing medication errors.
Elizabeth A Chrischilles1, Thomas R Fulda, Patricia J Byrns
1Department of Epidemiology, College of Public Health, University of Iowa, Iowa City 52242, USA. e-chrischilles@uiowa.edu
Evidence on computer-aided prospective drug utilization review (PDUR) systems is limited and inconclusive. More research is needed to determine the effectiveness of these drug safety tools and optimize their features for clinicians.
Area of Science:
- Health Informatics
- Pharmacoeconomics
- Clinical Pharmacy
Background:
- Computer-aided prospective drug utilization review (PDUR) systems aim to improve medication safety.
- Controversies exist regarding the effectiveness and optimal design of these systems.
Purpose of the Study:
- To review the existing evidence on computer-aided PDUR systems.
- To describe the controversies surrounding their implementation and use.
Main Methods:
- A literature search was conducted using MEDLINE.
- Included published studies evaluating the effectiveness of computer-aided prescription screening.
Main Results:
- The evidence base consists of one randomized controlled trial and four nonrandomized studies.
- Studies were inconclusive regarding whether screening systems prompt healthcare provider action.
- A randomized controlled trial found actions were taken even in the control group without alerts.
Conclusions:
- Limited evidence exists on the effectiveness and optimal features of computer-aided PDUR systems.
- This uncertainty may contribute to system variability and clinician doubt.
- Research on computer-aided PDUR effectiveness should be part of a national medical error reduction agenda.
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