Background
In recent years, there has been an expansion in the literature on the effects of computerized
alerts on prescribing and patient outcomes. The aim of our study was to examine the
impact of these systems on clinician prescribing and patient outcomes.
Methods
We searched three databases (Medline, Embase and PsychINFO) for studies that had been
conducted since 2009 and included studies that examined the effects of alerts at the
point of prescribing. We extracted data from 69 studies.
Results
Most studies reported a beneficial effect on prescribing of computerized alerts (n
= 58, 84.1%), including all studies (n=4) that used passive alerts. Seven of the 10
studies that reported on patient outcomes showed a beneficial effect. Both randomized
controlled trials (RCTs) and non-RCTS showed beneficial effects on prescribing across
a range of different types of alert. In 43 studies it was possible to ascertain the
effects of different types of alert; the interventions that were most frequently associated
with improvements in prescribing were drug-laboratory alerts (9/11; 81.8%); dose range
checking (6/7; 85.7%); formulary alerts (8/9; 88.9%) and drug-allergy alerts (4/4;
100%). However, most of the studies did not satisfy the quality criteria.
Conclusion
Most of the studies found a beneficial effect of computerized alerts on prescribing.
We have also shown that these benefits are apparent for a range of different types
of alert. These findings support continued development, implementation and evaluation
of computerized alerts for prescribing.
