The Effect of Computerized Alerts on Prescribing and Patient Outcomes: A Systematic Review.

Abstract

Background In recent years, there has been an expansion in the literature on the effects of computerized alerts on prescribing and patient outcomes. The aim of our study was to examine the impact of these systems on clinician prescribing and patient outcomes. Methods We searched three databases (Medline, Embase and PsychINFO) for studies that had been conducted since 2009 and included studies that examined the effects of alerts at the point of prescribing. We extracted data from 69 studies. Results Most studies reported a beneficial effect on prescribing of computerized alerts (n = 58, 84.1%), including all studies (n=4) that used passive alerts. Seven of the 10 studies that reported on patient outcomes showed a beneficial effect. Both randomized controlled trials (RCTs) and non-RCTS showed beneficial effects on prescribing across a range of different types of alert. In 43 studies it was possible to ascertain the effects of different types of alert; the interventions that were most frequently associated with improvements in prescribing were drug-laboratory alerts (9/11; 81.8%); dose range checking (6/7; 85.7%); formulary alerts (8/9; 88.9%) and drug-allergy alerts (4/4; 100%). However, most of the studies did not satisfy the quality criteria. Conclusion Most of the studies found a beneficial effect of computerized alerts on prescribing. We have also shown that these benefits are apparent for a range of different types of alert. These findings support continued development, implementation and evaluation of computerized alerts for prescribing.