Background Computerized physician order entry (CPOE) implementation in hospitals has become an important tool for interactive validation of medical orders as well as a facilitator for pharmacist interventions. However several studies have investigated the ‘alert fatigue’ phenomenon caused by an elevated number or recommendations which can lead to relevant clinical interventions being bypassed.
Purpose To compare the degree of acceptance of pharmacist’s interventions after medical order validation using CPOE versus direct phone conversation with the physician.
Materials and Methods Observational, descriptive and prospective study from May to August 2012.
The intervention chosen for comparing the systems was FDA recommendation for simvastatin use regarding contraindications and maximum recommended doses. Interventions were generated using a quasi-random allocation method and physicians could refuse recommendations.
When an intervention assigned to the telephone call group was not possible, CPOE was used as a second option. Acceptance of recommendations and time to modifications of the prescriptions were recorded.
Results Phone call: only 34 of 42 attempted interventions were possible due to the prescriber’s unavailability.
CPOE: 46 interventions and 54 interventions in total after the first attempt by phone call.
Rate of recommendations accepted was 82% for phone calls while only 52% of CPOE interventions.
Time to medical order modification since intervention was 0.26 days for the phone call group versus 2.18 days for CPOE group.
Conclusions CPOE is a useful tool for pharmacists to communicate with the multidisciplinary patient care team but when a relevant clinical intervention is necessary direct phone calls to prescribers are more effective and quicker.
No conflict of interest.
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