Adherence to drug-drug interaction alerts in high-risk patients: a trial of context-enhanced alerting.

摘要: Objective Drug–drug interaction (DDI) alerting is an important form of clinical decision support, yet physicians often fail to attend critical DDI warnings due alert fatigue. We previously described a model for highlighting patients at high risk by enhancing alerts with relevant laboratory data. sought evaluate the effect this on adherence in high-risk patients. Methods A 6-month randomized controlled trial involving 1029 outpatient was performed. The target interactions were all DDIs known cause hyperkalemia. Alerts intervention group enhanced patient's most recent potassium and creatinine levels. control received unmodified alerts. High -risk those baseline >5.0 mEq/l and/or ≥1.5 mg/dl (132 μmol/l). Results found no significant difference between (15.3%) (16.8%) (p=0.71). Adherence normal significantly lower (14.6%) than (18.6%) (p<0.01). In neither did increase risk. Conclusions Physicians adhere poorly hyperkalemia-associated even factors clinically interaction, display data these not improve levels setting. Further research necessary determine optimal strategies conveying patient-specific risk.