New York—Electronic prescribing systems too often provide incorrect warnings about medications.

That’s according to a survey of prescribing clinicians with an interest in psychopharmacology. A presentation at the recent American Society for Clinical (ASCP) Psychopharmacology points out a specific problem: Some warnings do not reflect product labeling information, such as maximum dose or contraindications.

As an example, Weill Cornell Medical College–led researchers cite the erroneous warning that selective serotonin reuptake inhibitors (SSRI) and aripiprazole are contraindicated for children and adolescents and might cause inadequate treatment of potentially life-threatening conditions.

Researchers emphasize their concern that most respondents to a survey administered to members of the ASCP reported being unable to alert the system about the inaccuracy of a prescribing warning.

Background information in the article notes that electronic prescribing is becoming widespread, with all states now allowing it, many requiring it, and many healthcare organizations mandating electronic prescribing. As part of the systems, computerized decision-support algorithms give automated warnings or alerts at the time of prescribing, if a potential prescribing error is identified in dosing or with contraindications.

“Some studies suggest that electronic prescribing alerts may reduce prescribing errors and can be clinically useful, but others caution that the warnings may have substantial limitations and that clinicians often consider them clinically irrelevant,” the study team writes. “Harmful unintended consequences of such prescribing alerts have been described.”

Yet, they add, no study has “focused primarily on the accuracy of systems regarding prescribing of psychotropic medications.”

Despite the findings, study authors conclude, “Nonetheless, automated electronic prescribing alerts are potentially useful; a limitation of our survey is that it did not assess the perceived usefulness of alerts or the balance of perceived benefits versus perceived risks. Other limitations include the low survey response rate and the small number of responses for some questions.”

They also note that the survey could not establish whether all alerts considered erroneous were actually erroneous.

“Additional studies of this topic are needed, especially given increasing use of electronic prescribing and potentially detrimental clinical consequences of inaccurate prescribing warnings,” the authors add.

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