Impact of clinical decision support preventing the use of QT-prolonging medications for patients at risk for torsade de pointes

Atsushi Sorita, J. Martijn Bos, Bruce W. Morlan, Robert F. Tarrell, Michael John Ackerman, Pedro Caraballo

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

We developed and implemented a 'CPOE-QT Alert' system, that is, clinical decision support integrated in the computerized physician order entry system (CPOE), in 2011. The system identifies any attempts to order medications with risk of torsade de pointes (TdP) for patients with a history of significant QT prolongation (QTc ≥500 ms) and alerts the provider entering the order. We assessed its impact by comparing orders and subsequent medication administration before and after activation of the system. We found a significant decrease in the proportion of completed order per ordering attempt after system activation (94% (1293/1379) vs 77% (1888/2453), difference 16.8%; p < 0.001). This resulted in a 13.9% reduction in the administration of those medications to patients. A significant decrease was observed across all provider types, educational levels, and specialties. The CPOE-QT Alert system successfully reduced exposure to QT-prolonging medications in high risk patients.

Original languageEnglish (US)
Pages (from-to)e21-e27
JournalJournal of the American Medical Informatics Association
Volume22
Issue numbere1
DOIs
StatePublished - 2015

Keywords

  • Clinical decision support
  • Computerized physician order entry
  • Medication management
  • QT prolongation
  • Torsade de pointes

ASJC Scopus subject areas

  • Medicine(all)

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