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Objective: The main objective of this study was to assess the diagnosticperformances of an alert system integrated into the CPOE/EMR system for renallycleared drug dosing control. The generated alerts were compared with the dailyroutine practice of pharmacists as part of the analysis of medication orders.Materials and Methods: The pharmacists performed their analysis of medicationorders as usual and were not aware of the alert system interventions that werenot displayed for the purpose of the study neither to the physician nor to thepharmacist but kept with associate recommendations in a log file. A seniorpharmacist analyzed the results of medication order analysis with and withoutthe alert system. The unit of analysis was the drug prescription line. Theprimary study endpoints were the detection of drug-dose prescription errors andinter-rater reliability between the alert system and the pharmacists in thedetection of drug dose error. Results: The alert system fired alerts in 8.41%(421/5006) of cases: 5.65% (283/5006) exceeds max daily dose alerts and 2.76%(138/5006) under dose alerts. The alert system and the pharmacists showed arelatively poor concordance: 0.106 (CI 95% [0.068, 0.144]). According to thesenior pharmacist review, the alert system fired more appropriate alerts thanpharmacists, and made fewer errors than pharmacists in analyzing drug doseprescriptions: 143 for the alert system and 261 for the pharmacists. Unlike thealert system, most diagnostic errors made by the pharmacists were falsenegatives. The pharmacists were not able to analyze a significant number (2097;25.42%) of drug prescription lines because understaffing. Conclusion: Thisstudy strongly suggests that an alert system would be complementary to thepharmacists activity and contribute to drug prescription safety.

Validity of a clinical decision rule based alert system for drug dose  adjustment in patients with renal failure intended to improve pharmacists'  analysis of medication orders in hospitals