A cluster randomized trial evaluating electronic prescribing in an ambulatory care setting.
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Date
2007-11-23
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Abstract
BACKGROUND Medication errors adverse drug events and potential adverse drug events are common and serious in terms of the harms and costs that they impose on the health system and those who use it Errors resulting in preventable adverse drug events have been shown to occur most often at the stages of ordering and administration This paper describes the protocol for a pragmatic trial of electronic prescribing to reduce prescription error The trial was designed to overcome the limitations associated with traditional study design DESIGN This study was designed as a 65 week cluster randomized parallel study METHODS The trial was conducted within ambulatory outpatient clinics in an academic tertiary care centre in Ontario Canada The electronic prescribing software for the study is a Canadian electronic prescribing software package which provides physician prescription entry with decision support at the point of care Using a handheld computer PDA the physician selects medications using an error minimising menu based pick list from a comprehensive drug database create specific prescription instructions and then transmit the prescription directly and electronically to a participating pharmacy via facsimile or to the physician s printer using local area wireless technology The unit of allocation and randomization is by week i e the system is on or off according to the randomization scheme and the unit of analysis is the prescription with adjustment for clustering of patients within practitioners DISCUSSION This paper describes the protocol for a pragmatic cluster randomized trial of point of care electronic prescribing which was specifically designed to overcome the limitations associated with traditional study design TRIAL REGISTRATION This trial has been registered with clinicaltrials gov ID NCT00252395
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Keywords
Facility-based health worker, Quality of care, Efficacy, Randomized, Experimental, Disease management, Electronic decision support, Text