CPOE systems ‘cut drug errors by half’

By Joanna Lyford, Senior medwireNews Reporter

The use of computerized provider order entry (CPOE) systems in US hospitals approximately halves the number of medication errors, research shows.

This equated to 17.4 million drug errors averted in a single year, say the researchers, who urge more hospitals to adopt the systems in order to improve patient safety.

CPOE systems are an electronic method for processing prescriptions and test requests. They aim to improve quality and safety by avoiding handwritten instructions and by providing inbuilt checks on doses and potentially harmful drug-drug interactions.

In this study, Lauren Olsho (Abt Associates Inc, Cambridge, Massachusetts, USA) and colleagues sought to estimate the degree to which CPOE reduces medication error in hospitals.

The research team conducted a meta-analysis of published studies, which was subsequently pooled with data from the 2006 American Society of Health-System Pharmacists Annual Survey, the 2007 American Hospital Association (AHA) Annual Survey, and the AHA's 2008 Electronic Health Record Adoption Database supplement.

Writing in the Journal of the American Medical Informative Association, Olsho et al report that using a CPOE system reduces the likelihood for prescription errors by 48%.

"Given this effect size, and the degree of CPOE adoption and use in hospitals in 2008, we estimate a 12.5% reduction in medication errors, or [approximately] 17.4 million medication errors averted in the USA in 1 year," the researchers write.

Despite the systems' effectiveness, however, the AHA survey found that just one in three acute care hospitals had adopted a CPOE system by 2008. Furthermore, 42% of hospitals with the system in place used it less than half the time, and just one-quarter used it to process 90% of requests.

The "modest" uptake of the system in US hospitals suggests there is "great potential" to further cut the tally of drug errors, Olsho and co-authors believe.

"If all US hospitals adopted CPOE, assuming constant implementation levels of around 60%, 51 million medication errors per year could be averted compared with what would have been expected without CPOE," they conclude. "Further research is needed to better characterize links to patient harm."

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