Related Experiment Video
Updated: May 24, 2026
07:31
Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
Provider-Related Determinants Influencing Drug-Drug Interaction Alert Handling in the Electronic Health Record
Kimmy Raven1, Stephanie Medlock1, Linda W Peute1
1Department of Medical Informatics Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
Studies in Health Technology and Informatics
|May 23, 2026
Summary
Prescriber characteristics like age and specialty influence how drug-drug interaction (DDI) alerts from clinical decision support systems (CDSS) are handled. Understanding these factors can improve alert effectiveness and patient safety.
Area of Science:
- Clinical Informatics
- Health Services Research
- Pharmacovigilance
Background:
- Drug-drug interaction (DDI) alerts are crucial components of clinical decision support systems (CDSS).
- A significant proportion of DDI alerts are not acted upon by prescribers, leading to potential patient safety risks.
- While alert characteristics are studied, prescriber-related factors influencing alert handling remain less understood.
Purpose of the Study:
- To identify provider-specific characteristics that influence the handling of DDI alerts within a CDSS.
- To explore the relationship between prescriber demographics, practice setting, and alert interaction behavior.
Main Methods:
- Analysis of alert interactions within electronic health record (EHR) data.
- Identification of key prescriber characteristics associated with alert handling decisions.
- Statistical analysis to determine significant determinants of influence.
Main Results:
- Seven key determinants of influence were identified: provider age, gender/role, specialty (internal vs. surgical), practice setting (inpatient vs. outpatient), and workload metrics (mean orders per year, mean patients per year).
- These factors provide insights into prescriber behavioral patterns and personal characteristics affecting DDI alert management.
Conclusions:
- Prescriber characteristics significantly impact the handling of DDI alerts.
- Understanding these determinants can inform strategies to enhance CDSS alert effectiveness.
- Improved alert handling has the potential to enhance overall patient safety by mitigating risks associated with unaddressed DDIs.
Related Concept Videos
01:25Pharmacokinetics: Drug–Drug Interactions
Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
01:24Drug Toxicity: Risk factors
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
01:30Drug toxicity: Drug–Drug Interaction
Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
01:26Pharmaceutical Poisoning: Potential Scenarios
Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
01:19Pharmacovigilance
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...