Do clinical decision support systems for prescribing improve patient safety? a systematic literature review

Abstract

Clinical decision support systems (CDSS) are developed independently or connected to the electronic health record (EHR) or other computerized systems. The study begins with identification by searching the literature through the Google Scholar, PubMed and ScienceDirect databases. The search results obtained 5,595 articles. Forty-two articles were obtained, which were used further. Most of the research focus is on "CDSS development and evaluation". In terms of impacts, the most common is "reduce prescribing errors". One of the biggest problems reported was the presence of "alert fatigue," which was felt to be disturbing to doctors and pharmacists. CDSS must be supported by a method that is able to indicate the presence of drug-drug interactions (DDI). The use of alerts indicating the presence of a DDI should be interpreted using clinical judgment to determine the risks and benefits of a particular drug for a specific patient. The performance of CDSS is mostly reported to have been able to reduce prescribing errors, which in turn will improve patient safety. However, increased adherence to clinical protocols has not been widely reported. Complaints that are still quite a lot reported are the presence of "alert fatigue", which can interfere with effectiveness.