Researchers caution warning when using electronic prescribing, as errors are likely to occur in medical record systems.
Electronic prescribing is becoming increasingly common across the world. All states in America allow it, some states require it, and many institutions now mandate electronic prescribing. Some studies suggest that electronic prescribing alerts may reduce prescribing errors and can be clinically useful, however, others warn that they may have substantial limitations and that clinicians often consider them clinically irrelevant.
What do you know about electronic prescribing?
Many electronic prescribing systems use computerised decisions supported by algorithms that give automated warnings or alerts at the time of prescribing if a potential prescribing error is identified i.e. regarding dosing or contraindications.
Nevertheless, harmful unintended consequences of such prescribing alerts have been described. Despite the importance of this issue, few studies have examined the accuracy of automated prescribing warnings in electronic prescribing systems and currently there has been no study that has focused primarily on the accuracy of systems regarding prescribing of psychotropic medications.
To examine this issue, The American Society of Clinical Psychopharmacology were surveyed regarding automated warnings generated by electronic prescribing systems.
What have researchers found?
A substantial proportion of prescribing clinicians with an interest in psychopharmacology believe that their electronic prescribing system has provided incorrect prescribing warnings, posing potential problems in the pharma industry.
It is particularly problematic that some warnings do not reflect product labelling information – for example, regarding maximum dose or contraindications. Such mistakes could have profound consequences, such as causing inadequate treatment of potentially life-threatening conditions.
It is also concerning that most respondents reported being unable to alert the system about the inaccuracy of a prescribing warning.
Nevertheless, automated electronic prescribing alerts are potentially useful; a drawback of the survey conducted is that it did not assess the perceived usefulness of alerts or the balance of perceived benefits versus perceived risks. Moreover, it is not known whether all alerts considered erroneous were erroneous. Additional studies of this topic are required, especially given increasing use of electronic prescribing and potentially detrimental clinical consequences of inaccurate prescribing warnings.
