Overriding Drug-Drug Interaction Alerts in Clinical Decision Support Systems: A Scoping Review

Area of Science:

• Informatics
• Clinical Decision Support
• Pharmacovigilance

Background:

• Computerized alerts for Drug-Drug Interactions (DDI) are often ineffective.
• Clinicians frequently override these alerts due to issues like lack of context and clinical relevance.

Purpose of the Study:

• To review published data on the rate of DDI alert overrides.
• To identify common medications involved in alert overrides.

Main Methods:

• Systematic review of 34 eligible studies.
• Data collected from sites across Asia, Europe, the United States, and the United Kingdom.

Main Results:

• DDI alert override rates varied widely, from 55% to 98%.
• Over half of the studies reported specific drug pairs or medications frequently involved in alert overrides.

Conclusions:

• High rates of DDI alert overrides necessitate improved clinical decision support systems.
• Future systems should consider user, drug, and institutional factors.
• Actionable metrics are needed to assess harm from alert overrides.