Structure of Electronic Decision Aid Prompts Affects Prescribing

Design changes to electronic decision aid order sets can alter the way physicians prescribe, according to a study published in the British Medical Journal for Quality and Safety.

Researchers tested changes to order sets with a simplistic order set: mouthwash prescription in intensive care units. They added chlorhexidine to the default prescribing template. Hydroxethyl starch, another mouthwash formula, had already been removed from the prescribing template the previous year.

Approximately 55 percent of patients treatable with chlorhexidine received the mouthwash before the intervention, while 90.4 percent received chlorhexidine after researchers had added it to the prescribing template. Researchers also had access to prescription data before and after the removal of hydroxethyl starch. Another direct association was observed in that data, with 54.1 percent of patients receiving hydroxethyl starch while it was on the template and 3.1 percent receiving it after it had been removed from the template.

The study concludes knowledge of this effect has the potential to improve the effectiveness of electronic prescribing systems and computerized order sets.

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