Journal Article

Structured override reasons for drug–drug interaction alerts in electronic health records.

Wright A; McEvoy DS; Aaron S; McCoy AB; Amato MG; Kim H; Ai A; Cimino JJ; Desai BR; El-Kareh R; Galanter W; Longhurst CA; Malhotra S; Radecki RP; Samal L; Schreiber R; Shelov E; Sirajuddin AM; Sittig DF.

Alerts designed to notify providers of possible drug–drug interactions can be helpful in preventing adverse drug events, but they can also lead to alert fatigue and other unintended consequences. Prior research has shown that providers frequently override these alerts for various reasons. In this study, researchers analyzed information on drug–drug interaction alerts and reasons they were overridden across a variety of electronic health records from 10 different clinical sites. They found 177 distinct override reasons, and many of the reasons for override available to clinicians were not actually relevant to drug–drug interactions. The authors suggest that there is significant opportunity to improve the clinical utility of drug–drug interaction alerts to make them more meaningful for providers. An Annual Perspective highlighted some of the challenges associated with computerized decision support.