Effects of Computerized Physician Order Entry on Prescribing Practices

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Abstract
SUBSTANTIAL DATA suggest that the quality of medication prescribing by physicians could be improved. Underprescribing, overprescribing, incorrect choice of drugs, and failure to recognize adverse effects are serious and potentially avoidable occurrences. There are many documented examples of suboptimal prescribing. For instance, in 1992 and 1993, only 53% of eligible patients with myocardial infarction received a β-blocker, despite convincing data that this practice prolongs life1; additionally, 20% of patients who were ineligible for lidocaine hydrochloride received it nonetheless. A study in nursing homes found that a hypnotic drug was prescribed for 40% of patients, even though evidence exists that these agents are not effective for long-term use.2 Another study found that patients receiving metoclopramide were 3.1 times as likely as patients who were not receiving metoclopramide to begin levodopa therapy,3 suggesting that physicians failed to recognize drug-induced symptoms in some of these patients. Prescribing errors are a significant cause of injuries; in one study of hospitalized patients, 56% of preventable adverse drug events were primarily related to errors in prescribing.4