Modulators Influencing Medication Alert Acceptance: An Explorative Review.

Area of Science:

• Health Informatics
• Medical Safety
• Human-Computer Interaction

Background:

• Clinical decision support systems (CDSSs) utilize alerts to improve medication safety and decrease errors.
• Low acceptance rates of medication alerts hinder their potential benefits.
• A comprehensive overview of factors affecting alert acceptance is currently lacking.

Purpose of the Study:

• To systematically review and compile qualitative and quantitative modulators of alert acceptance.
• To organize these modulators into a comprehensive model for better understanding.
• To identify research gaps and suggest future study designs for quantifying alert modulator effects.

Main Methods:

• A systematic literature search was conducted in PubMed from February 2018 to October 2021, adhering to PRISMA guidelines.
• Extracted qualitative and quantitative parameters impacting alert acceptance from included articles.
• Grouped parameters into factors and determinants, categorized by CDSS, care provider, patient, setting, and drug.

Main Results:

• 60 articles yielded 391 parameters, grouped into 75 factors and 25 determinants.
• Over half of factors were qualitatively assessed or quantitatively inconclusive.
• 33 quantitative factors significantly influenced alert acceptance (e.g., alert type, comorbidity, alert frequency, number of alerts).

Conclusions:

• This review synthesizes modulators of alert acceptance, differentiating between quantitative and qualitative influences.
• The study highlights the need for further research to comprehensively quantify the impact of various alert modulators.
• Understanding these factors is crucial for optimizing CDSS alert design and improving medication safety.