Table 1 Summary of results for CCDSS trials of drug prescribing

Field, 2009[17, 24]

Alerts to promote appropriate drug prescribing and monitoring for patients with renal insufficiency in long-term care.

1*/10/833

Appropriate final drug orders.

Fortuna, 2009[18]

Alerts to consider cost when prescribing hypnotics for adults in primary and urgent care.

14*/257/...

Change in hypnotic drug prescriptions.

Lo, 2009[20]

Alerts to order laboratory tests when prescribing new medications in primary care.

22*/366/2765

Ordering appropriate baseline laboratory tests.

Terrell, 2009[23]

Alerts to avoid inappropriate prescriptions in geriatric outpatients during discharge from emergency care.

1/63*/5,162

Emergency department visits resulting in prescriptions for ≥1 of the 9 targeted inappropriate medications.

Gurwitz, 2008[25]

Alerts to prevent adverse drug events in long-term care.

2*/37/1,118

...

Hicks, 2008[26]

Reminders for management of hypertension in adults in primary care.

14*/.../2,027

Visits with adherence to guideline medication prescribing within one week.

Matheny, 2008[28]

Reminders for routine medication laboratory monitoring in primary care.

20*/303/1,922

Ordering appropriate laboratory tests.

Reeve, 2008[30]

Reminders for use of aspirin in diabetic adults in primary care.

52*/150/258,979

Number of aspirin interventions in diabetic patients.

Davis, 2007[32]

Alerts for appropriate prescribing for upper respiratory tract infections in paediatric outpatients.

2/44*/12,195

Prescriptions consistent with recommendations.

Heidenreich, 2007[33]

Reminders to prescribe β-blockers for inpatients and outpatients with reduced LVEF.

3/50/1,546*

Patients with prescriptions for any β-blocker over nine months.

Martens, 2007[34, 46]

Reminders for prescribing of antibiotics and drugs for asthma, COPD, and dyslipidaemia.

23*/53/3,496

Sum scores for appropriate prescribing of antibiotics, statins, cholesterol-lowering drugs or drugs for asthma or COPD.

Peterson, 2007[35]

Dosing advice for high-risk drugs in geriatric patients in a tertiary care academic health centre.

1/778/2,981*

Ratio of overall prescribed to recommended doses.

Raebel, 2007a[37]

Alerts to review potentially inappropriate prescriptions in ambulatory geriatric patients.

21/.../59,680*

Dispensings of targeted potentially inappropriate medications.

Raebel, 2007b[36]

Alerts to avoid teratogenic drugs in pregnant ambulatory patients.

.../.../11,100*

Dispensed category D or X drugs.

Thomson, 2007[38]

Presented information for treatment decisions about warfarin or aspirin therapy for patients with atrial fibrillation in primary care.

2/2/109*

Difference in decision conflict scale score immediately post-clinic.

Verstappen, 2007[39]

Management of methotrexate for early rheumatoid arthritis in adult outpatients.

6/.../299*

...

Feldstein, 2006a[22, 41]

Alerts to order laboratory tests when prescribing new medications in primary care.

15*/200/961

Baseline laboratory monitoring completed by day 25.

Judge, 2006[42]

Alerts to avoid inappropriate prescriptions in long-term care.

1*/27/445

Appropriate prescriber response to alerts.

Kattan, 2006[43]

Feedback provided for management of drug therapy for severe asthma in paediatric outpatients.

.../435/937*

Time to compliance with recommended therapy step; visits resulting in medication step-up after step-up recommendation.

Palen, 2006[47]

Reminders for laboratory monitoring based on medication orders in primary care.

16/207*/26,586

Overall compliance with ordering the recommended laboratory monitoring.

Paul, 2006[48]

Recommendations for empiric antibiotic treatment in hospital inpatients.

15*/.../2,326

Overall rate of appropriate antibiotic treatment.

Derose, 2005[50]

Reminders to prescribe ACE-Is, angiotensin receptor blockers and/or statins in outpatients with diabetes or atherosclerosis.

.../1089/8,557*

Patients with prescriptions for at least one of ACE-I, angiotensin receptor blocker, or statin.

Heidenreich, 2005[51]

Reminders to prescribe ACE-I or alternative for inpatients and outpatients with reduced LVEF.

1/.../600*

Patients with prescriptions for ≥ moderate daily dose of ACE-I or appropriate alternative.

Raebel, 2005[54]

Alerts to order laboratory tests when prescribing new medications in primary care.

.../.../400,000*

Laboratory test completed at time prescription is dispensed.

Krall, 2004[58]

Alerts to prescribe of low dose aspirin therapy in primary care.

.../100*/10,972

Provider response to alerts (prescribe aspirin or document contraindication).

Ansari, 2003[61]

Alerts to prescribe β-blockers for patients with heart failure in primary care.

1/74*/169

Initiated or uptitrated and maintained on β-blockers; patients at target β-blocker dose.

Filippi, 2003[62]

Reminders to prescribe acetylsalicylic acid or other antiplatelet agents to diabetic primary care patients.

.../300*/15,343

Antiplatelet drug prescription.

Tamblyn, 2003[65]

Alerts to avoid inappropriate prescriptions in geriatric outpatients.

.../107*/12,560

Proportion of new inappropriate prescriptions; discontinuation of pre-existing inappropriate prescriptions.

Weir, 2003[67]

Recommendations for appropriate prescribing of anti-platelet and/or anti-coagulant drugs following stroke or transient ischemic attack for in- and out-patients

16*/.../1,952

Number of optimal treatments provided and rank of therapy prescribed.

Zanetti, 2003[68]

Alert to redose prophylactic antibiotics during prolonged cardiac surgery.

1/.../447*

Intraoperative redose of antibiotics.

Christakis, 2001[73]

Recommendations for appropriate prescribing of antibiotics for otitis media in paediatric outpatients.

1/38*/488

Antibiotics prescribed for <10 days.

Rossi, 1997[81]

Reminders to modify drug therapy in hypertensive outpatients receiving calcium channel blockers as initial therapy.

1/71/719*

Prescription changes from a calcium channel blocker to another antihypertensive agent.

Rotman, 1996[83]

Alerts to prescribe lowest cost drug alternative for adult outpatients.

1/37*/...

Rate of clinically relevant drug interactions.

McDonald, 1980[87]

Detection and management of medication-related problems in outpatients.

1/31*/...

Response rate for reminders over five weeks.

Coe, 1977[88]

Recommendations for medication management of hypertension in patients attending hypertension clinics.

2/.../116*

...

McDonald, 1976[89]

Recommendations for laboratory tests to detect potential medication-related events in adults attending a diabetes clinic.

1/.../226*

Ordered required tests to monitor drug effects; appropriate response to abnormal measures.

Bertoni, 2009[16, 21]

Recommendations for screening and treatment of dyslipidaemia in primary care.

59*/.../3,821

Patients with appropriate lipid management at follow-up.

Gilutz, 2009[19]

Reminders for monitoring and treatment of dyslipidaemia in primary care patients with known coronary artery disease.

112*/600/7,448

Appropriate initiation, up-titration, or continuation of statin therapy; adequate lipoprotein monitoring.

Javitt, 2008[27]

Patient-specific recommendations for detecting and correcting medical errors in a health maintenance organization setting.

1/1378/49,988*

Resolution for problems identified by care considerations by adding or stopping a drug.

Quinn, 2008[29]

Recommendations for management of type 2 diabetes in primary care using remote glucose monitoring.

3/26/30*

Medications intensified; Medication errors identified.

Van Wyk, 2008[31]

On-demand and automatic alerts to screen and treat dyslipidaemia in primary care.

38*/80/92,054

Patients requiring treatment were treated.

Feldstein, 2006b[40]

Reminders for monitoring and treatment of osteoporosis care in high-risk women in primary care who experienced a fracture.

15/159/311*

Received only osteoporosis medication within 6 months of study start.

Kuilboer, 2006[44]

Recommendations for monitoring and treatment of asthma and COPD in primary care.

32*/40/156,772

Number of prescriptions for respiratory drugs.

Lester, 2006[45, 59]

Recommendations for the management of dyslipidaemia in primary care.

1/14/235*

Change in statin prescriptions at 1 and 12 months.

Cobos, 2005[49]

Recommendations for treatment, monitoring and follow-up for patients with dyslipidaemia in primary care.

42*/.../2,221

Assessed AST/ALT measurements or creatine kinase determinations; use of lipid-lowering drugs in patients with CHD or those without CHD and at high-risk or low-risk.

Javitt, 2005[52]

Recommendations for management of patients whose care deviates from recommended practices in primary care.

.../.../39,462*

Compliance with recommendations to add or discontinue a medication.

Plaza, 2005[53]

Recommendations for cost-effective management of asthma in primary care.

.../20*/198

Prescriptions of oral glucocorticoids

Sequist, 2005[55]

Reminders for management of diabetes and coronary artery disease in primary care.

20*/194/6,243

Receipt of recommended drugs in diabetes (statins, ACE-Is in hypertension) or coronary artery disease (including aspirin, β-blocker or statin use).

Tierney, 2005[56]

Recommendations for the management of asthma and chronic obstructive pulmonary disease in adults in primary care.

4/266*/706

Suggestions adhered to for starting, modifying or stopping bronchodilators; medication compliance; patient satisfaction with physicians and pharmacists.

Wolfenden, 2005[57]

Reminders to provide smoking cessation interventions to patients attending non-cardiac pre-operative clinic.

1/18/210*

Preoperative nicotine replacement therapy offered or prescribed.

Murray, 2004[60]

Recommendations for treatment of hypertension in primary care.

4/...*/712

Compliance with all antihypertensive drug suggestions; patient satisfaction.

Tierney, 2003[66]

Recommendations for management of heart disease in primary care.

4*/115/706

Adherence with care suggestions to start low-dose aspirin or antihyperlipidemic drugs, or start or increase an ACE-Is, β-blockers, diuretics, long-acting nitrates, or calcium blockers.

Eccles, 2002[64, 69]

Recommendations for management of asthma or angina in adults in primary care.

62*/.../4,506

Prescription of β-blockers for angina patients.

Flottorp, 2002[63, 70]

Recommendations for management of urinary tract infections in women or sore throat in primary care.

142*/.../...

Use of antibiotics for sore throat and urinary tract infections.

Lesourd, 2002[71]

Recommendations for hormonal ovarian stimulation for infertile women in a teaching hospital.

3/4/164*

...

Selker, 2002[72]

Recommendations for thrombolytic and other reperfusion therapy in acute myocardial infarction.

28/.../1,596*

Patients who had ST-segment elevation detected but did not have acute myocardial infarction, including those who received thrombolytic therapy and those who had contraindications; thrombolytic therapy prescribed within one hour of acute myocardial infarction.

Dexter, 2001[74]

Reminders for preventive therapies in hospital inpatients.

...*/202/3,416

Hospitalizations with an order for prophylactic heparin or aspirin at discharge (all patients and only eligible patients).

McCowan, 2001[75]

Recommendations and reminders for management of asthma in primary care.

...*/46/477

Received prescription for acute asthma exacerbations.

Demakis, 2000[76]

Reminders for screening, monitoring, and counselling in accordance with predefined standards of care in ambulatory care.

12*/275/12,989

Adherence to recommendations for international normalised ratio monitoring in warfarin users, anticoagulation in atrial fibrillation, β-blocker following myocardial infarction or change in non-steroidal anti-inflammatory drug therapy following gastrointestinal bleed.

Hetlevik, 1999[77–79]

Recommendations for diagnosis and management of hypertension, diabetes mellitus, and dyslipidaemia in primary care.

56*/56/3,273

...

Overhage, 1997[80]

Recommendations for corollary orders to prevent errors of omission for tests and treatments in general medicine inpatients.

1*/92/2,181

Pharmacist interventions with physicians for significant errors.

Overhage, 1996[82]

Reminders to comply with 22 US Preventive Services Task Force preventive care measures for hospital inpatients.

1*/78/1,622

Compliance with preventive care guidelines for use of aspirin, oestrogen or calcium, ACE-Is, heparin prophylaxis, and β-blockers.

Tierney, 1993[84]

Alerts for drug allergies and drug-drug interactions, and options for cost-effective testing in inpatients.

6*/276/5,219

...

Mazzuca, 1990[85]

Reminders for the management of type 2 diabetes mellitus in outpatients.

4*/114/279

Initiation of oral hypoglycaemic therapy.

McAlister, 1986[86]

Recommendations for management of hypertension in primary care.

50/50*/2,231

Patients receiving treatment for hypertension.