Researchers: Make duplicate medication alerts more specific

Duplicate medication (DM) alerts do not often lead to prescription modifications, but do lead to other actions, according to research published online this week in the Journal of the American Medical Informatics Association. To that end, changes to alerts should be considered, the study's authors say.

The researchers examined drug therapy alerts sent through clinical decision support systems (CDSS). One type of alert is a duplicate medication alert, used to detect unwarranted duplication of therapeutic groups or active ingredients. Researchers had 53 community pharmacists collect DM alerts for one year, and each pharmacist had to register 24 DM alerts in daily practice, according to the study.

They ended up with 1,258 alerts, which were categorized by the type of alert. The study's authors found that one-fifth of those led to external action by the pharmacist, such as instructing the patient or informing a healthcare provider. Modifications to prescriptions were rare, with only 2.2 percent of the 1,258 alerts leading to that action.

They concluded that CDSS is helpful in detecting inappropriate DM alerts, but that nonspecific alerts could lead to "alert fatigue."

"Strategies to improve the specificity of DM alerts should be considered," the researchers say.

Some ways to do this, they say, include:

  • Enabling different overlap criteria per therapeutic class
  • Allowing suppression of repeat DM alerts
  • Considered use of advanced clinical decision support 

Electronic health record clinical decision support systems have also been found helpful in prescribing antibiotics for patients suffering from acute respiratory infections, which helps to ensure the appropriateness of those prescriptions, according to a Journal of General Internal Medicine study.

To learn more:
- here's the study