Researchers Examine Overrides of Drug-Drug Interaction Alerts

Clinicians frequently override critical drug-drug interaction alerts in electronic health record (EHR) systems and one study found that more than 30% of alert overrides put patients at significant risk for adverse events. The results, published online December 26, 2013, in PLoS One, suggest that managing medication alert overrides will remain an important strategy for preventing patient harm. Researchers examined how and why clinicians overrode drug-drug interaction alerts over a three-year period from January 1, 2009, to December 31, 2011, at primary care practices affiliated with two Harvard teaching hospitals. As part of the study, the EHR was modified to produce fewer but more meaningful interruptive alerts. Of the overrides considered to be inappropriate, there was an increased risk of several specific conditions, including serotonin syndrome (21.5%), cardiotoxicity (16.5%), and sharp falls in blood pressure or significant hypotension (28.5%).