The poor agreement between compendia suggests that this methodology may not be ideal for the evaluation of DDI alerts. Presenting alerts in the context of patient cases allowed panelists to identify the conditions under which alerts were clinically relevant. Using an expert panel and allowing them to discuss their views openly likely resulted in high agreement on what alerts should be included in a CPOE system. On the other hand, the panel reached consensus on 12 of the 13 alerts that were presented to them regarding whether they should be included in the CPOE. Only 10% of DDI alerts were classed as severe by all compendia.
There was poor agreement between compendia in their classifications of DDI severity (Krippendorff's α: 0.03 95% confidence interval: –0.07 to 0.14). = 13), with associated patient information, were presented to an expert panel to reach a consensus on whether each alert should be included in the CPOE. In this study, we aimed to evaluate clinical relevance of alerts prior to implementation in CPOE using two common approaches: compendia and expert panel review.Īfter generating a list of hypothetical DDI alerts, that is, alerts that would have been triggered if DDI alerts were operational in the CPOE, we calculated the agreement between multiple drug interaction compendia with regards to the severity of these alerts.
This increases the risk of prescribers experiencing too many irrelevant alerts, resulting in alert fatigue. Drug–drug interaction (DDI) alerts are often implemented in the hospital computerized provider order entry (CPOE) systems with limited evaluation.