Improving ambulatory prescribing safety with a handheld decision support system: a randomized controlled trial

Authors: 
Berner, E. S., Houston, T. K., Ray, M. N., Allison, J. J., Heudebert, G. R., Chatham, W. W., Kennedy, J. I. = Jr, Glandon, G. L., Norton, P. A., Crawford, M. A., Maisiak, R. S.
Journal: 
J Am Med Inform Assoc
Publication Date: 
2006 Mar-Apr
Volume: 
13
Issue: 
2
Pages: 
171-9
  • HIT Description: Decision support, mobile computing More info...
  • Purpose of Study: To evaluate the effectiveness of a personal digital assistant (PDA) containing a clinical devision support system (CDSS) on nonsteriodal anti-inflammatory drug (NSAID) prescribing safety
  • Years of study: Not Available
  • Study Design: Randomized controlled trial
  • Outcomes: Impact on patient safety
Summary:
  • Settings: Urban university-based resident-staffed clinic
  • Intervention: Internal medicare residents were randomized to receiving PDAs with or without a decision support program related to NSAIDs and GI risks. Residents evaluated actors trained to portray patients with musculoskeletal symptoms, their assessment and treatment plans were recorded.
  • Evaluation Method: Review of visit documentation to assess safety of prescribed medication.
  • Description: PDA ran the Palm Operating System (OS) 4.01. Six months after PDAs were distributed to residents, decision support system MedDecide, developed using Satellite Forms Version $ for Palm, was added. Intervention group received module for GI risk assessment for NSAIDS. All participants also received Epocrates, Medcalc, Medmath, and a breast cancer risk calculator.
  • Strategy: One 30 minute training session was held for small grouops of participants at a time.
  • Quality of Care and Patient Safety Outcome: The mean proportion of cases per physician with unsafe NSAID prescriptions in the intervention group was about one-half that of the physicians without access to the module.