The effectiveness of integrated health information technologies across the phases of medication management: a systematic review of randomized controlled trials
| Autor: | K Ann McKibbon, Anne Holbrook, Robyn Tamblyn, Cynthia Lokker, Brian J Hemens, Sue Troyan, Daria O'Reilly, Pavel S Roshanov, Steven M. Handler, Lisa Dolovich, Runki Basu |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Decision support system Medication Therapy Management Psychological intervention MEDLINE Health Informatics Review Clinical decision support system Health informatics Medical Order Entry Systems law.invention Randomized controlled trial Nursing law Health care Medication therapy management Humans Medicine Randomized Controlled Trials as Topic business.industry Decision Support Systems Clinical Systems Integration Outcome and Process Assessment Health Care Family medicine business Medical Informatics |
| Zdroj: | Journal of the American Medical Informatics Association. 19:22-30 |
| ISSN: | 1527-974X 1067-5027 |
| DOI: | 10.1136/amiajnl-2011-000304 |
| Popis: | Objective The US Agency for Healthcare Research and Quality funded an evidence report to address seven questions on multiple aspects of the effectiveness of medication management information technology (MMIT) and its components (prescribing, order communication, dispensing, administering, and monitoring). Materials and Methods Medline and 11 other databases without language or date limitations to mid-2010. Randomized controlled trials (RCTs) assessing integrated MMIT were selected by two independent reviewers. Reviewers assessed study quality and extracted data. Senior staff checked accuracy. Results Most of the 87 RCTs focused on clinical decision support and computerized provider order entry systems, were performed in hospitals and clinics, included primarily physicians and sometimes nurses but not other health professionals, and studied process changes related to prescribing and monitoring medication. Processes of care improved for prescribing and monitoring mostly in hospital settings, but the few studies measuring clinical outcomes showed small or no improvements. Studies were performed most frequently in the USA (n¼63), Europe (n¼16), and Canada (n¼6). Discussion Many studies had limited description of systems, installations, institutions, and targets of the intervention. Problems with methods and analyses were also found. Few studies addressed order communication, dispensing, or administering, non-physician prescribers or pharmacists and their MMIT tools, or patients and caregivers. Other study methods are also needed to completely understand the effects of MMIT. Conclusions Almost half of MMIT interventions improved the process of care, but few studies measured clinical outcomes. This large body of literature, although instructive, is not uniformly distributed across settings, people, medication phases, or outcomes. |
| Databáze: | OpenAIRE |
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