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Search results for "Ambulatory Care"
Journal Article > Commentary
Schiff G, Mirica MM, Dhavle AA, Galanter WL, Lambert B, Wright A. Health Aff (Millwood). 2018;37:1877-1883.
Although electronic prescribing has been shown to reduce prescribing errors, the impact on adverse drug events remains less certain. Overriding of drug–drug interaction alerts and inclusion of free-text notes that contain inaccurate information within electronic prescriptions suggests that safe prescribing requires more than an electronic system. To improve the safety of electronic prescribing, the authors make several broad recommendations. They suggest including drug indications on prescriptions, ensuring a readily available and accurate medication list, notifying pharmacies when previously prescribed medications are canceled, using standard prescription instructions, improving decision support, and promoting consideration of nondrug options. A previous WebM&M commentary discussed an incident involving an electronic prescribing error.
The Moore Foundation provides free access to this article.
Journal Article > Study
Potential safety gaps in order entry and automated drug alerts: a nationwide survey of VA physician self-reported practices with computerized order entry.
Spina JR, Glassman PA, Simon B, et al. Med Care. 2011;49:904-910.
In contrast to most hospitals and clinics, the Veterans Affairs (VA) health care system has had a fully electronic health record with computerized provider order entry for several years. In this survey, VA physicians generally had positive impressions of the system, with nearly 90% feeling the system improved drug safety and nearly half reporting that serious drug interaction warnings were "very useful." However, the accuracy of drug–drug interaction and allergy warnings within this system are partially dependent upon clinicians manually entering medications prescribed by non-VA providers. As more than one quarter of respondents admitted to not always entering this data, this study highlights the importance of medication reconciliation in establishing accurate medication lists in the ambulatory care setting.
MacLennan PA, Owsley C, Rue LW III, McGwin G Jr. Washington, DC: American Automobile Association Foundation for Traffic Safety; August 2009.
This report provides results of a survey about older adults' awareness of common medications that may impair the ability to drive.
Journal Article > Study
Grizzle AJ, Mahmood MH, Ko Y, et al. Am J Manag Care. 2007;13:573-580.
This study discovered that more than 70% of overrides identified in a computerized provider order entry (CPOE) system were for critical drug–drug interactions. The authors also point out that 53% of providers offered no clinical justification for such overrides, raising questions about the system's need for redesign.
Cases & Commentaries
- Web M&M
Tom Bookwalter, PharmD; June 2004
A woman given is found cyanotic on morning rounds. Her methemoglobinemia is determined to be from a roughly 7-fold overdose of dapsone.