By a News Reporter-Staff News Editor at Clinical Trials Week -- Fresh data on Health and Medical Informatics are presented in a new report. According to news reporting from Kingston, Canada, by NewsRx journalists, research stated, "Inadequate lab monitoring of drugs is a potential cause of ADEs (adverse drug events) which is remediable. To determine the effectiveness of computerized drug-lab alerts to improve medication-related outcomes."
The news correspondents obtained a quote from the research from Queen's University, "Citations from the Computerized Clinical Decision Support System Systematic Review (CCDSSR) and MMIT (Medications Management through Health Information Technology) databases, which had searched MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts from 1974 to March 27, 2013. Study selection: Randomized controlled trials (RCTs) of clinician-targeted computerized drug lab alerts conducted in any healthcare setting. Two reviewers performed full text review to determine study eligibility. Data abstraction: A single reviewer abstracted data and evaluated validity of included studiesusing Cochrane handbook domains. Data synthesis: Thirty-six studies met the inclusion criteria (25 single drug studies with 22,504 participants, 14 targeting anticoagulation; 11 multi-drug studies with 56,769 participants). ADEs were reported as an outcome in only four trials, all targeting anticoagulants. Computerized drug-lab alerts did not reduce ADEs (OR 0.89, 95% CI 0.79-1.00, p = 0.05), length of hospital stay (SMD 0.00, 95% CI -0.93 to 0.93, p = 0.055, 1 study), likelihood of hypoglycemia (OR 1.29, 95% CI 0.31-5.37) or likelihood of bleeding, but were associated with increased likelihood of prescribing changes (OR 1.73, 95% CI 1.21-2.47) or lab monitoring (OR 1.47, 95% confidence interval 1.12-1.94) in accordance with the alert."
According to the news reporters, the research concluded: "There is no evidence that computerized drug-lab alerts are associated with important clinical benefits, but there is evidence of improvement in selected clinical surrogate outcomes (time in therapeutic range for vitamin K antagonists), and changes in process outcomes (lab monitoring and prescribing decisions)."
For more information on this research see: The effectiveness of computerized drug-lab alerts: A systematic review and meta-analysis. International Journal of Medical Informatics, 2014;83(6):406-415. International Journal of Medical Informatics can be contacted at: Elsevier Ireland Ltd, Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland. (Elsevier - www.elsevier.com; International Journal of Medical Informatics - www.elsevier.com/wps/product/cws_home/506040)
Our news journalists report that additional information may be obtained by contacting I. Bayoumi, Queen's University, Dept. of Family Med, Kingston, ON K7L 3N6, Canada. Additional authors for this research include M. Al Balasd, S.M. Handler, L. Dolovich, B. Hutchison and A. Holbrook (see also Health and Medical Informatics).
Keywords for this news article include: Canada, Ontario, Kingston, Computers, North and Central America, Clinical Trials and Studies, Health and Medical Informatics
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