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Appl Clin Inform 2025; 16(02): 295-304
DOI: 10.1055/a-2481-4221
Research Article

Facilitators and Barriers to Uptake of Drug–Drug Interaction Alerts: Perspectives of Australian End Users and Managers

Kristian Stanceski
1   Faculty of Medicine and Health, Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
,
Bethany A. Van Dort
1   Faculty of Medicine and Health, Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
,
Teresa Lee
2   Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
,
Andrew J. McLachlan
2   Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
,
Richard O. Day
3   Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
4   Clinical Pharmacology & Toxicology, St Vincent's Clinical School, The University of New South Wales, St Vincent's Clinical Campus, St Vincent's Hospital, Victoria Street, Darlinghurst, New South Wales, Australia
,
Sarah N. Hilmer
5   Departments of Clinical Pharmacology and Aged Care, Kolling Institute of Medical Research, Faculty of Medicine and Health, The University of Sydney and Northern Sydney Local Health District, St Leonards, New South Wales, Australia
6   Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, St Leonards, New South Wales, Australia
,
Ling Li
7   Australian Institute of Health Innovation, Centre for Health Systems and Safety Research, Macquarie University, North Ryde, New South Wales, Australia
,
Johanna Westbrook
7   Australian Institute of Health Innovation, Centre for Health Systems and Safety Research, Macquarie University, North Ryde, New South Wales, Australia
,
Wu Yi Zheng
1   Faculty of Medicine and Health, Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
8   Black Dog Institute, University of New South Wales, Hospital Rd, Randwick, New South Wales, Australia
,
Michael Barras
9   Pharmacy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
10   School of Pharmacy, The University of Queensland, St Lucia, Queensland, Australia
,
Karma Z.S. Mekhail
11   Pharmacy Department, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia
,
Melissa T. Baysari
1   Faculty of Medicine and Health, Biomedical Informatics and Digital Health, School of Medical Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
› Author Affiliations Funding This work is supported by the National Health and Medical Research Council (Partnership Grant: APP1134824) in partnership with eHealth NSW and eHealth QLD (Department of Health and Aged Care, Australian Government, National Health and Medical Research Council).
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Abstract

Background Drug–drug interaction (DDI) alerts in electronic systems are frequently implemented to minimize the occurrence of preventable DDIs. While prescribers recognize the potential benefits of DDI alerts, a large proportion are overridden by users.

Objectives This study aimed to explore and compare prescribers' and managers' perspectives of DDI alerts.

Methods A qualitative descriptive study was conducted across six hospitals in Australia with end users (prescribers who receive alerts) [n = 14] and managers [n = 20] (senior staff in roles relevant to alert system implementation and management). End users were asked to reflect on alert usefulness, benefits, risks, and impacts. Managers were asked what they thought of alerts, and about any feedback they had received from frontline clinicians. Key themes were extracted via an inductive content analysis approach and deductively mapped to the Technology Acceptance Model (TAM3). Comparisons of the views held toward the alerts were made between the two participant groups.

Results End users predominantly reflected on the utility of the DDI alert system (i.e. how useful it was to their role), less on how easy the system was to use, and mainly focused on the negative consequences of alerts. Managers believed the benefits of DDI alerts are primarily experienced by junior doctors. While end users suggested that alerts should be tailored to the patient's clinical scenario, managers called for DDI alerts to be tailored to the prescriber (seniority and specialty).

Conclusion Interviews with end users and managers uncovered a number of perceived benefits and limitations of DDI alerts, primarily related to the system's usefulness. While largely consistent, some perceptions were different between end users and managers, particularly in the types of benefits, and how they conceptualized potential tailoring to improve DDI alerts. Our findings point to a need for user participation in the development, deployment, and improvement of alerts to promote consideration and effectiveness of DDI alerts.

Keywords

clinical decision support - drug interactions - perceptions - quality improvement

Authors' Contributions

M.T.B., L.L., J.W., S.N.H., and R.O.D. conceived the study. M.T.B. and K.Z.S.M. assisted with recruitment and M.T.B., B.A.V.D., T.L., and K.S. undertook data collection and analysis. All authors provided input to the study design, and interpretation of findings. All authors contributed to and approved the final manuscript.


Protection of Human and Animal Subjects

Ethics approval was obtained from one of the hospital's Human Research Ethics Committee (February 18, 2021/4.07) and site approval obtained from all participating sites. The study was conducted in accordance with the aforementioned committee's parameters.


Supplementary Material



Publication History

Received: 11 June 2024

Accepted: 21 November 2024

Article published online:
02 April 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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