Document Detail


Impact of clinical decision support preventing the use of QT-prolonging medications for patients at risk for torsade de pointes.
MedLine Citation:
PMID:  25324555     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We developed and implemented a 'CPOE-QT Alert' system, that is, clinical decision support integrated in the computerized physician order entry system (CPOE), in 2011. The system identifies any attempts to order medications with risk of torsade de pointes (TdP) for patients with a history of significant QT prolongation (QTc ≥500 ms) and alerts the provider entering the order. We assessed its impact by comparing orders and subsequent medication administration before and after activation of the system. We found a significant decrease in the proportion of completed order per ordering attempt after system activation (94% (1293/1379) vs 77% (1888/2453), difference 16.8%; p<0.001). This resulted in a 13.9% reduction in the administration of those medications to patients. A significant decrease was observed across all provider types, educational levels, and specialties. The CPOE-QT Alert system successfully reduced exposure to QT-prolonging medications in high risk patients.
Authors:
Atsushi Sorita; J Martijn Bos; Bruce W Morlan; Robert F Tarrell; Michael J Ackerman; Pedro J Caraballo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-16
Journal Detail:
Title:  Journal of the American Medical Informatics Association : JAMIA     Volume:  -     ISSN:  1527-974X     ISO Abbreviation:  J Am Med Inform Assoc     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-17     Completed Date:  -     Revised Date:  2014-10-18    
Medline Journal Info:
Nlm Unique ID:  9430800     Medline TA:  J Am Med Inform Assoc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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