Not useful or difficult to use? Clinicians’ grievances against drug-drug interaction alerts.

Abstract

Background: Medications that are harmful when concurrently prescribed contribute to adverse drug events in hospitalised patients. Drug-drug interaction (DDI) alerts are designed to notify prescribers of potentially harmful drug combinations, yet are often ignored by prescribing clinicians.

Aims: The aim of this study was to explore prescribers’ perceptions of DDI alerts and to identify key barriers impeding integration of the system into prescriber decision-making.

Methods: Semi-structured interviews were conducted with clinicians from two major Australian hospitals. Questions focussed on how users interact with DDI alerts, as well as aspects of the alerts that hinder clinician integration of the system into prescriber decision-making. Common themes were extracted from interviews by two researchers and subsequently mapped to the relevant determinants in the Technology Acceptance Model-3 (TAM3).

Results: Factors relating to usefulness of the alert system were the most frequently raised barriers to routine use of alerts during prescribing tasks. These included clinicians’ perceptions of the system’s relevance to their role and the degree to which their tasks benefit from having alerts in place. In contrast, perceptions relating to how easy the system was to navigate were less frequently mentioned.

Conclusions: In order to increase the uptake of DDI alerts, they need to be more useful, or perceived to be more useful by prescribers. This can be achieved through demonstrating the utility of alerts to users, as well as improving the objective value that the system provides by, for example, improving the clinical relevance of alerts to individual patients.