5PSQ-029 The overriding of drug safety alerts fired by the clinical decision support tool: evaluation of appropriate responses and alert fatigue solutions

Background and Importance Most CPOE software come with clinical decision support (CDS) that assist prescribers and notify them about adverse drug reactions that play an important role in reducing medication errors and enhancing patient safety. An excessive number of alerts in a repeated and non-relevant manner leads to alert fatigue and enforces physicians and pharmacists to alert overrides. Aim and Objectives Our primary objective was to determine which alerts are overridden and their association with an appropriate action. To assess the appropriate responses for red alerts (pDDI, overdose, and allergy). Our second objective was to decrease the number of unnecessary red alerts. Material and Methods The study was a retrospective chart review carried out in the inpatient setting that included all red alerts that required comments and were overridden by a physician and pharmacist. Results In this retrospective study, we determined which alerts are clinically irrelevant and need modifications. We found that more than half of the alerts were pDDI, and the drug allergy alerts had the most appropriate responses by both prescribers and pharmacists when compared to other alert classes (OR = 1.65, OR = 1.54, respectively; p < 0.05). For diminishing the unnecessary alerts, we provided 14 alert refinement strategies and advised turning off four alerts. Applying this will terminate 32% of irrelevant alerts. Conclusion and Relevance In this retrospective study, we described which alerts are clinically irrelevant and need modifications. We found that more than half of the alerts were pDDI, and the drug allergy alerts had the most appropriate responses by both prescribers and pharmacists when compared to other alert classes (OR = 1.65, OR = 1.54, respectively; p < 0.05). We anticipate that our recommendations can lead to consistent and clinically relevant content for interruptive DDIs, and thus decline alert fatigue and enhance patient safety. References and/or Acknowledgements 1. Sutton RT, Pincock D, Baumgart DC, Sadowski DC, Fedorak RN, Kroeker KI. NPJ Digit Med. 2020;3:17. 10.1038/s41746–020-0221-y 2. Helmons PJ, Suijkerbuijk BO, Nannan Panday PV, Kosterink JG. J Am Med Inform Assoc. 2015;22:764–72.10.1093/jamia/ocu010 3. Khreis NA, Lau ASM, Al-Jedai A, Al-Khani S, Alruwaili EH. Int J Comput Commun Eng. 2019;8:32–9. 4. Simpao AF, Ahumada LM, Desai BR, et al. J Am Med Inform Assoc. 2015;22:361–9. 10.1136/amiajnl-2013–002538 Conflict of Interest No conflict of interest.