Prescribers' responses to alerts during medication ordering in the long term care setting

Computerized physician order entry (CPOE) with clinical decision support (CDS) has been shown to improve medication safety in adult inpatients, but few data are available regarding its usefulness in the long-term care setting. The objective of this randomized controlled study was to examine opportunities for improving medication safety by determining the proportion of medication orders that would generate a warning message to the prescriber via a computerized CDS system and assessing the extent to which these alerts would affect prescribers' actions. Long-term care facilities must implement new system-level approaches with the potential to improve medication safety for their residents. The number of medication orders that triggered a warning message in this study (19.6%) suggests that CPOE with a CDS system may represent one such tool. However, the relatively low rate of response to these alerts (31%) suggests that further refinements to such systems are required, and that their impact on medication errors and adverse drug events must be carefully assessed.