Clinical decision support eliminated 42% of duplicate orders for medication

A computerized physician order entry (CPOE) system with a clinical decision support (CDS) system could reduce duplicate medications and adverse drug reactions, according to a study published in JMIR Medical Informatics.

In this study, researchers from Taipei Medical University in Taiwan outlined the development of PharmaCloud, a national mediation repository and online query system, and its impact on reducing medication duplication and adverse drug reactions. The system allows physicians to gain access to the medication records of patients, even from different healthcare organizations from across Taiwan.

Researchers began by developing the CDS to download patients' medication history from the PharmaCloud to detect duplicate medications and if a duplicate is detected, the physician receives an alert. Data on time, prescribes drugs and physician responses were collected for three months.

A total of 178,000 prescriptions were prescribed and 43,844 received content from patients allowing physicians access to their medication history though PharmaCloud. Results showed the rate of medication duplication was 5.83 percent, but 42 percent of those potential duplications were flagged and eventually canceled.

“The CDS engine could easily extend functions for detection of adverse drug reactions when more and more electronic health record systems are adopted. Moreover, the CDS engine can retrieve more updated and completed medication histories in the PharmaCloud, so it can have better performance for detection of duplicate medications,” wrote first author Cheng-Yi Yang, PhD, and colleagues. “The successful key component of a CDS engine is the completeness of the patient’s medication history, thus further research to assess the factors in increasing the PharmaCloud consent rate is required.”