Physicians' responses to computerized drug interaction alerts with password overrides

Area of Science:

• Medical Informatics
• Clinical Pharmacy
• Patient Safety

Background:

• Computerized drug-drug interaction (DDI) alert systems aim to reduce DDIs.
• However, high alert volumes can lead to clinician burden and alert overrides.

Purpose of the Study:

• To analyze physician responses to DDI alerts requiring password overrides.
• To evaluate the effectiveness and burden of a specific DDI alert system.

Main Methods:

• Retrospective analysis of DDI alerts at Hokkaido University Hospital (Dec 2011-Nov 2012).
• Physician responses (cancellation or override via password) to contraindication alerts were recorded.

Main Results:

• 170 contraindication alerts were generated; 65.3% were overridden.
• The most frequent alert involved statins and fibrates.
• No DDIs were reported for overridden contraindications.

Conclusions:

• Password-protected DDI alert systems can enhance medication safety.
• The override process may impose a significant workload on physicians.
• Future systems should balance patient safety with physician efficiency.