Outcomes of a decision support prompt in community pharmacy‐dispensing software to promote step‐down of proton pump inhibitor therapy

Curtain, Colin; Peterson, Gregory M.; Tenni, PC; Bindoff, Ivan; Williams, Mackenzie

doi:10.1111/j.1365-2125.2010.03890.x

Cited by 26 publications

(62 citation statements)

References 11 publications

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“…Of these, 11 studies were evaluated as having a high risk of bias [55-59, 61, 63-67] and three studies assessed as having an unclear risk of bias [54,60,62]. Several domains contributed to risk of bias in multiple studies.…”

Section: Study Characteristics Including Risk Of Bias Assessmentsmentioning

confidence: 99%

“…Economic outcomes were determined in three studies [54,59,62]. All the economic evaluations looked at different measurements.…”

Section: Characteristics Of Outcome Measures Including Quality Of Evimentioning

confidence: 99%

“…Implementation activities were targeted to community pharmacy, and in particular to pharmacists in 20 studies [54][55][56][57][58][59][60][61][62][65][66][67][68][69][70][71][72][73][74][75] and pharmacy support staff in 11 studies [56, 58, 61-64, 66, 68, 69, 72, 75]. In two studies, implementation activities were directed exclusively to pharmacy support staff, while three studies involved implementation activities to other health professionals and/or patients as well as community pharmacy staff [58,65,70].…”

Section: Implementation Strategies and Their Effectivenessmentioning

confidence: 99%

“…The 22 studies comprised 10 RCTs [54][55][56][57][58][59][60][61][62][63], 3 NRCTs [64][65][66], 1 CBA trial [67] and 8 quasi-experimental or observational studies [68][69][70][71][72][73][74][75] (Tables 1 and 2). The studies were conducted in Australia (n = 8) [54-56, 60, 64, 65, 68, 69], the USA (n = 4) [57][58][59]73], the UK (n = 3) [62,63,75], the Netherlands (n = 2) [61,72], Belgium (n = 1) [67], Canada, (n = 1) [71], Finland (n = 1) [74], Germany (n = 1) [70] and Switzerland (n = 1) [66].…”

Section: Study Characteristics Including Risk Of Bias Assessmentsmentioning

confidence: 99%

“…visits or phone calls) to provide motivation and support to practitioners post education inadequacies were due to lack of reporting or flaws in research design. Two of the studies evaluated as having an overall unclear risk of bias used implementation strategies involving a computer prompt [54,60]. The Newcastle-Ottawa tool for cohort studies was used to evaluate eight studies [68][69][70][71][72][73][74][75].…”

Section: Study Characteristics Including Risk Of Bias Assessmentsmentioning

confidence: 99%

See 4 more Smart Citations

Effectiveness of implementation strategies for clinical guidelines to community pharmacy: A systematic review

Watkins

Wood

Clifford

et al. 2016

Research in Social and Administrative Pharmacy

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Section: Study Characteristics Including Risk Of Bias Assessmentsmentioning

confidence: 99%

“…Economic outcomes were determined in three studies [54,59,62]. All the economic evaluations looked at different measurements.…”

Section: Characteristics Of Outcome Measures Including Quality Of Evimentioning

confidence: 99%

Section: Implementation Strategies and Their Effectivenessmentioning

confidence: 99%

Section: Study Characteristics Including Risk Of Bias Assessmentsmentioning

confidence: 99%

Section: Study Characteristics Including Risk Of Bias Assessmentsmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of implementation strategies for clinical guidelines to community pharmacy: A systematic review

Watkins

Wood

Clifford

et al. 2016

Research in Social and Administrative Pharmacy

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Orders for Intravenous Proton Pump Inhibitors After Implementation of an Electronic Alert

et al. 2015

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The effects of on-screen, point of care computer reminders on processes and outcomes of care

Shojania

Jennings²,

Mayhew

et al. 2009

Cochrane Database of Systematic Reviews

362

339

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Background The opportunity to improve care by delivering decision support to clinicians at the point of care represents one of the main incentives for implementing sophisticated clinical information systems. Previous reviews of computer reminder and decision support systems have reported mixed effects, possibly because they did not distinguish point of care computer reminders from e-mail alerts, computer-generated paper reminders, and other modes of delivering ‘computer reminders’. Objectives To evaluate the effects on processes and outcomes of care attributable to on-screen computer reminders delivered to clinicians at the point of care. Search methods We searched the Cochrane EPOC Group Trials register, MEDLINE, EMBASE and CINAHL and CENTRAL to July 2008, and scanned bibliographies from key articles. Selection criteria Studies of a reminder delivered via a computer system routinely used by clinicians, with a randomised or quasi-randomised design and reporting at least one outcome involving a clinical endpoint or adherence to a recommended process of care. Data collection and analysis Two authors independently screened studies for eligibility and abstracted data. For each study, we calculated the median improvement in adherence to target processes of care and also identified the outcome with the largest such improvement. We then calculated the median absolute improvement in process adherence across all studies using both the median outcome from each study and the best outcome. Main results Twenty-eight studies (reporting a total of thirty-two comparisons) were included. Computer reminders achieved a median improvement in process adherence of 4.2% (interquartile range (IQR): 0.8% to 18.8%) across all reported process outcomes, 3.3% (IQR: 0.5% to 10.6%) for medication ordering, 3.8% (IQR: 0.5% to 6.6%) for vaccinations, and 3.8% (IQR: 0.4% to 16.3%) for test ordering. In a sensitivity analysis using the best outcome from each study, the median improvement was 5.6% (IQR: 2.0% to 19.2%) across all process measures and 6.2% (IQR: 3.0% to 28.0%) across measures of medication ordering. In the eight comparisons that reported dichotomous clinical endpoints, intervention patients experienced a median absolute improvement of 2.5% (IQR: 1.3% to 4.2%). Blood pressure was the most commonly reported clinical endpoint, with intervention patients experiencing a median reduction in their systolic blood pressure of 1.0 mmHg (IQR: 2.3 mmHg reduction to 2.0 mmHg increase). Authors’ conclusions Point of care computer reminders generally achieve small to modest improvements in provider behaviour. A minority of interventions showed larger effects, but no specific reminder or contextual features were significantly associated with effect magnitude. Further research must identify design features and contextual factors consistently associated with larger improvements in provider behaviour if computer reminders are to succeed on more than a trial and error basis.

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Outcomes of a decision support prompt in community pharmacy‐dispensing software to promote step‐down of proton pump inhibitor therapy

Cited by 26 publications

References 11 publications

Effectiveness of implementation strategies for clinical guidelines to community pharmacy: A systematic review

Effectiveness of implementation strategies for clinical guidelines to community pharmacy: A systematic review

Orders for Intravenous Proton Pump Inhibitors After Implementation of an Electronic Alert

The effects of on-screen, point of care computer reminders on processes and outcomes of care

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