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The Effects of Clinical Decision Support Systems on Medication Safety: An Overview

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  • Pengli Jia
  • Longhao Zhang
  • Jingjing Chen
  • Pujing Zhao
  • Mingming Zhang

Abstract

Background: The clinical decision support system(CDSS) has potential to improving medication safety. However, the effects of the intervention were conflicting and uncertain. Meanwhile, the reporting and methodological quality of this field were unknown. Objective: The aim of this overview is to evaluate the effects of CDSS on medication safety and to examine the methodological and reporting quality. Methods: PubMed, Embase and Cochrane Library were searched to August 2015. Systematic reviews (SRs) investigating the effects of CDSS on medication safety were included. Outcomes were determined in advance and assessed separately for process of care and patient outcomes. The methodological quality was assessed by Assessment of Multiple Systematic Reviews (AMSTAR) and the reporting quality was examined by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Twenty systematic reviews, consisting of 237 unique randomized controlled trials(RCTs) and 176 non-RCTs were included. Evidence that CDSS significantly impacted process of care was found in 108 out of 143 unique studies of the 16 SRs examining this effect (75%). Only 18 out of 90 unique studies of the 13 SRs reported significantly evidence that CDSS positively impacted patient outcomes (20%). Ratings for the overall scores of AMSTAR resulted in a mean score of 8.3 with a range of scores from 7.5 to 10.5. The reporting quality was varied. Some contents were particularly strong. However, some contents were poor. Conclusions: CDSS reduces medication error by obviously improving process of care and inconsistently improving patient outcomes. Larger samples and longer-term studies are required to ensure more reliable evidence base on the effects of CDSS on patient outcomes. The methodological and reporting quality were varied and some realms need to be improved.

Suggested Citation

  • Pengli Jia & Longhao Zhang & Jingjing Chen & Pujing Zhao & Mingming Zhang, 2016. "The Effects of Clinical Decision Support Systems on Medication Safety: An Overview," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-17, December.
    • Handle: RePEc:plo:pone00:0167683
    DOI: 10.1371/journal.pone.0167683
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    References listed on IDEAS

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    1. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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    1. Tâmara Natasha Gonzaga de Andrade Santos & Givalda Mendonça da Cruz Macieira & Bárbara Manuella Cardoso Sodré Alves & Thelma Onozato & Geovanna Cunha Cardoso & Mônica Thaís Ferreira Nascimento & Paulo, 2020. "Prevalence of clinically manifested drug interactions in hospitalized patients: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-14, July.

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