Reasons for Physician Non-Adherence to Electronic Drug Alerts.

We often link prescription drugs with relief - a safe treatment for an illness or disorder. But, the safety of such drugs depends on a reliable prescription system. The prescription system that is used by doctors today is prone to error. Prescription errors can lead to serious health problems and even death. In fact, these problems are the sixth leading cause of death in North America. The MOXXI project aims to help decrease these problems by giving an electronic prescribing system to family doctors. These systems can alert doctors of the harmful effects a prescribed drug may have on their patients. We explored the reasons for why some doctors ignore these drug alerts.
A personal digital assistant (PDA) plays a key role in the drug alert system. It flags drug problems like dosing errors, patient allergies or problems due to age factors. It can also tell the doctor whether the patient is taking another drug that may badly react with the prescription. For three months, 30 family doctors used the PDA for 6260 prescriptions. During the study period, 1869 alerts were generated. Of these alerts, 45% led to changed decisions and 55% were ignored. We asked why some doctors ignored these drug alerts.
The most common reasons for ignoring alerts were that the drug problem was already known or that it was not clinically relevant to the patient situation. Most reasons were linked to the doctor having more knowledge of the patient's medical situation than the PDA. This feedback will help further improve this drug alert system.