| Evaluation of laboratory monitoring alerts within a computerized physician order entry system for medication orders. | |
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MedLine Citation:
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PMID: 16834525 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Errors involving medication use are common. Computerized physician order entry (CPOE) can improve prescribing practices. Few studies have examined the effect of CPOE in combination with decision support tools on prescribing practices in the outpatient setting. Less is known about prescribers' adherence to laboratory monitoring recommendations. OBJECTIVE: To evaluate if reminders presented during CPOE for medications would increase physicians' compliance with guidelines for laboratory monitoring at initiation of therapy. STUDY DESIGN: Randomized prospective intervention study. METHODS: Two hundred seven primary care physicians in a group-model managed care organization were randomized to receive or not receive drug laboratory monitoring alerts within the CPOE system. Adherence to laboratory monitoring recommendations for patients prescribed selected medications was compared between physician groups. RESULTS: There was no significant difference between the control and intervention group physicians in the overall rate of compliance with ordering the recommended laboratory monitoring for patients prescribed study medications. Laboratory monitoring was performed as recommended 56.6% of the time in the intervention group compared with 57.1% of the time in the control group (P = .31). In cases in which a statistically significant difference was demonstrated, improved compliance favored the intervention group (eg, 71.2% vs 62.3% [P = .003] for gemfibrozil and 75.7% vs 73.9% [P = .05] for statins). CONCLUSIONS: As CPOE becomes more prevalent, additional research is needed to determine effective decision support tools. These findings then should be communicated to the developers and users of computerized medical record systems. |
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Authors:
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Ted E Palen; Marsha Raebel; Ella Lyons; David M Magid |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: The American journal of managed care Volume: 12 ISSN: 1088-0224 ISO Abbreviation: Am J Manag Care Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-07-12 Completed Date: 2006-09-15 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 9613960 Medline TA: Am J Manag Care Country: United States |
Other Details:
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Languages: eng Pagination: 389-95 Citation Subset: H |
Affiliation:
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Clinical Research Unit, Colorado Permanente Medical Group, PO Box 378066, Denver, CO 80237-8066, USA. ted.e.palen@kp.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Adverse Drug Reaction Reporting Systems Aged Aged, 80 and over Ambulatory Care / standards Clinical Laboratory Information Systems* Decision Support Systems, Clinical* Drug Monitoring / methods* Female Guideline Adherence Humans Male Managed Care Programs / standards Medical Order Entry Systems* Medical Records Systems, Computerized Middle Aged Primary Health Care / standards Reminder Systems* Safety Management Treatment Outcome United States |
| Grant Support | |
ID/Acronym/Agency:
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U18 HS11843/HS/AHRQ HHS |
| Comments/Corrections | |
Comment In:
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Am J Manag Care. 2006 Jul;12(7):369-70
[PMID:
16834523
]
Am J Manag Care. 2006 Sep;12(9):563; author reply 563 [PMID: 16961445 ] Am J Manag Care. 2006 Jul;12(7):365-6 [PMID: 16834522 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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