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Updated: Aug 28, 2025
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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
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Implementing evidence-based anticoagulant prescribing: User-centered design findings and recommendations
F Jacob Seagull1, Michael S Lanham2,3,4, Michelle Pomorski5
1Center for Bioethics and Social Science in Medicine Michigan Medicine Ann Arbor Michigan USA.
Research and Practice in Thrombosis and Haemostasis
|September 16, 2022
Summary
User-centered design (UCD) improves direct oral anticoagulant (DOAC) alerts, reducing prescription errors. This study provides actionable recommendations for effective DOAC prescribing alerts in electronic health record systems.
Area of Science:
- Clinical Informatics
- Pharmacovigilance
- Health IT
Background:
- Direct oral anticoagulants (DOACs) are frequently prescribed but associated with significant prescription errors and adverse drug events.
- Clinical decision support alerts can mitigate errors, yet their quality and effectiveness vary.
- User-centered design (UCD) is a promising strategy to enhance the efficacy of medication alerts.
Purpose of the Study:
- To develop effective direct oral anticoagulant (DOAC) prescription alerts utilizing a user-centered design (UCD) approach.
- To formulate generalizable design recommendations for clinical decision support alerts.
Main Methods:
- An iterative UCD process involving practicing clinicians was employed.
- Prototype alert designs were developed and refined over three rapid design and assessment cycles.
- Simulated patients within a test electronic health record (EHR) environment were used for evaluation.
Main Results:
- The study included 13 prescribers from various specialties.
- Key design recommendations focus on indication clarity, renal function-based dosing, tailored drug interaction alerts, alert trust, and minimizing user burden.
- Final alert designs incorporated these evidence-based recommendations.
Conclusions:
- A user-centered design process yielded crucial recommendations for implementing effective medication alerts for direct oral anticoagulant (DOAC) prescribing.
- These guidelines offer a framework for optimizing DOAC alerts across diverse electronic health record (EHR) systems.
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