Implementation of medication alert systems and pharmacist satisfaction: a questionnaire-based study

Area of Science:

• Clinical Informatics
• Health Services Research
• Pharmacovigilance

Background:

• Medication alert systems (MAS) are key components of clinical decision support systems, vital for preventing medication errors.
• However, widespread alert fatigue often diminishes the effectiveness of MAS.
• Limited data exists on the specific implementation and utilization of MAS functions in Japanese clinical settings.

Purpose of the Study:

• To clarify the implementation status of specific MAS functions in Japanese hospitals.
• To identify challenges encountered during the real-world use of MAS.
• To distinguish between alerts intended for physicians (primary) and pharmacists (secondary).

Main Methods:

• A questionnaire-based study was conducted among pharmacists at 65 hospitals in Iwate Prefecture, Japan.
• The survey assessed MAS implementation, functionality, and pharmacist satisfaction using a 7-point Likert scale.
• Data were analyzed and summarized using medians and interquartile ranges (IQR).

Main Results:

• A high implementation rate for both primary (85.4%) and secondary (80.5%) alert systems was observed.
• Drug-drug contraindication checks were widely implemented, unlike disease contraindication and drug allergy checks, which showed significant variation.
• Pharmacist satisfaction with secondary alerts was moderate (median: 5), but lower for disease contraindication (median: 2) and drug allergy checks (median: 2.5), citing excessive alerts and clinical judgment discrepancies.

Conclusions:

• Despite widespread MAS implementation in Japan, significant variations in alert functions and usage exist between hospitals and healthcare professionals.
• Pharmacists frequently experience dissatisfaction due to excessive alerts, discrepancies with clinical judgment, and system limitations.
• Further improvements in disease contraindication and drug allergy alert functions are needed, alongside optimized alert settings and enhanced clinical relevance to promote effective MAS use and medication safety.