Objective: Computerized physician order entry (CPOE) systems are widely used to prevent medication errors in hospitals. However, the associated systems need to be optimized regularly to improve effectiveness. This study aims to analyze pharmacist intervention through an optimized drug allergy alert system and changes in outpatient drug allergy reporting rates.
Methods: This retrospective study, conducted from October, 2012 to March, 2019 among four hospitals in Northern Taiwan, analyzed reporting trends in outpatient drug allergy cases over the two-stage optimization of the CPOE system during the study period. During the first stage, pharmacists have intervened monthly to integrate drug allergy coding and were proactively reminded to optimize the auditing system since April, 2013. During the second stage, physicians have been required to enter a reason when prescribing allergy inducing medicines since October, 2018. We have compared changes in the outpatient drug allergy reporting rate for 6 months before and after optimization.
Results: We have identified a total of 7,988,666 outpatient cases and 981 drug allergy cases for 6 months before and after the two intervention stages. After the first stage, the outpatient drug allergy reporting rate increased from 0.08‰ (158/1,943,130) to 0.14‰ (284/1,975,992). After the second stage, the reporting rate decreased from 0.23‰ (459/2,020,812) to 0.04‰ (80/2,048,732). The trends in reporting rates were similar among the four hospitals.
Conclusions: Optimization of drug allergy alerting in a CPOE system can not only significantly reduce prescription errors involving known allergenic drugs, but also improve pharmacists’ monitoring of prescriptions for patient medication safety.
Summited for publication: 2021.1.26; Accepted for publication: 2021.5.15