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

• 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
  

• 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.