Do computerised clinical decision support systems for prescribing change practice? A systematic review of the literature (1990-2007)
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* Corresponding author: Sallie-Anne Pearson sallie.pearson@unsw.edu.au
1 UNSW Cancer Research Centre, University of New South Wales and Prince of Wales Clinical School, Sydney, Australia
2 Discipline of Clinical Pharmacology, School of Medicine and Public Health, The University of Newcastle, Australia
3 National Prescribing Service Limited, Sydney, Australia
BMC Health Services Research 2009, 9:154 doi:10.1186/1472-6963-9-154
Published: 28 August 2009Additional files
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Full search strategy.
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Table S1 - Full summary of results - Initiating treatment. a Other clinical areas include: salicylates or paracetamol in patients with history of GI bleed; erythropoietin low Hb; HIV medications; various medications. b Other clinical areas include: various medications interacting with warfarin; various conditions in children (e.g. croup, otitis media)
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Table S2 - Full summary of results - Monitoring treatment. c Other clinical areas include: hormone treatment for infertility; etretinate for psoriasis; HIV medications; various conditions (e.g. epilepsy, gout, diabetes).
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Table S3: Key study features and results (Initiating treatment - Before drug selection). * Unless otherwise stated, number of patients is close to or equal to that specified in the "participants" column, or was not reported. + (NS) indicates intervention favoured the CDSS but was not statistically significant; - (NS) indicates intervention favoured comparison group but was not statistically significant; 0 = no difference between groups; ++ indicates intervention favoured CDSS and was statistically significant; - - indicates intervention favoured comparator and was statistically significant; U = unclear. ACE = angiotensin-converting enzyme; BMD = bone mineral density; BP = blood pressure; CAD = coronary artery disease; CDSS = computerised clinical decision support system; CHD = coronary heart disease; CHF = congestive heart failure; CME = continuing medical education; CPOE = computerised provider order entry; COPD = chronic obstructive pulmonary disease; CVD = cardiovascular disease; EMR = electronic medical record; GI = gastro intestinal; GP = general practitioner; Hgb = haemoglobin; HIV = human immuno-deficiency virus; HMO = Health Maintenance Organisation; IHD = ischemic heart disease; LDL = low-density lipoprotein; MI = myocardial infarction; NSAIDs = non-steroidal anti-inflammatory drugs; NYHA = New York Heart Association; PCP = P carinii pneumonia; RCT = randomised controlled trial; UTI = urinary tract infection;
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Table S4: Key study features and results (Initiating treatment - After drug selection). * Unless otherwise stated, number of patients is close to or equal to that specified in the "participants" column, or was not reported. + (NS) indicates intervention favoured the CDSS but was not statistically significant; - (NS) indicates intervention favoured comparison group but was not statistically significant; 0 = no difference between groups; ++ indicates intervention favoured CDSS and was statistically significant; - - indicates intervention favoured comparator and was statistically significant; U = unclear. CDSS = computerised clinical decision support system; CPOE = computerised provider order entry; COPD = chronic obstructive pulmonary disease; CNS = central nervous system; CVD = cardiovascular disease; ED = emergency department; EMR = electronic medical record; GP = general practitioner; HMO = Health Maintenance Organisation; ICU = intensive care unit; IV = intravenous; MRSA = methicillin-resistant Staphylococcus aureus; NSAIDs = non-steroidal anti-inflammatory drugs; RCT = randomised controlled trial; TCA = tertiary amine tricyclics antidepressant.
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Table S5: Key study features and results (Monitoring existing therapy). * Unless otherwise stated, number of patients is close to or equal to that specified in the "participants" column, or was not reported. + (NS) indicates intervention favoured the CDSS but was not statistically significant; - (NS) indicates intervention favoured comparison group but was not statistically significant; 0 = no difference between groups; ++ indicates intervention favoured CDSS and was statistically significant; - - indicates intervention favoured comparator and was statistically significant; U = unclear. ACE = angiotensin-converting enzyme; BP = blood pressure; ALT = alanine aminotransferase; AST = aspartate aminotransferase; CBC = complete blood count; CDSS = computerised clinical decision support system; CHD = coronary heart disease; CME = continuing medical education; CPOE = computerised provider order entry; COPD = chronic obstructive pulmonary disease; EMR = electronic medical record; FSH = follicle-stimulating hormone; HIV = human immuno-deficiency virus; HMO = health maintenance organisation; INR = international normalised ratio; IV = intravenous; LFT = liver function test; LH = luteinizing hormone; NYHA = New York Heart Association; PTR = prothrombin time ratio; RCT = randomised controlled trial; TSH = thyroid stimulating hormone;
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Table S6: Key study features and results (Stopping treatment). * Unless otherwise stated, number of patients is close to or equal to that specified in the "participants" column, or was not reported. + (NS) indicates intervention favoured the CDSS but was not statistically significant; - (NS) indicates intervention favoured comparison group but was not statistically significant; 0 = no difference between groups; ++ indicates intervention favoured CDSS and was statistically significant; - - indicates intervention favoured comparator and was statistically significant; U = unclear. CDSS = computerised clinical decision support system; CPOE = computerised provider order entry; COPD = chronic obstructive pulmonary disease; EMR = electronic medical record; FSH = follicle-stimulating hormone; GP = general practitioner; LH = luteinizing hormone; NSAID = non-steroidal anti-inflammatory drugs; NYHA = New York Heart Association; RCT = randomised controlled trial.
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Table S7: Key differences between the studies included in the current review and previous reviews. * Studies were not prescribing focused (screening, preventive care/disease management). † Studies addressed automated drug dosing studies without decision support. # Review excluded studies below a defined quality rating. ‡ Review did not include monitoring or ceasing studies.
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