An Evaluation of Drug-Drug Interaction Alerts Produced by Clinical Decision Support Systems in a Tertiary Hospital

IntroductionDrug-drug interactions (DDIs) have the potential to harm patients. Hence, DDI alerts are meant to prevent harm; as a result, their usefulness is reduced when most alerts displayed to providers are ignored. This study aims to explore the rates and reasons for overriding alerts of DDI.MethodsThis is a retrospective study of DDI alert overrides that occurred between January 2020 and December 2020 within the inpatient medical records at a tertiary hospital, Medina City, Kingdom of Saudi Arabia.ResultsA total of 7,098 DDI alerts were generated from inpatient settings, of which 6,551(92.2%) were overridden by the physicians at the point of prescribing. “Will Monitor as Recommended” (33%) was the most common reason for the override, followed by ‘Will Adjust the Dose as Recommended (27.1%),” “The Patient Has Already Tolerated the Combination” (25.7%), and “No Overridden Reason Selected” (13.0%).DiscussionThe DDI alert overriding is still high and is comparable to other studies. However, this study reveals that physicians are ready to deal with the consequences of around 58% of DDI alerts. Additionally, 13% of physicians were not willing to report the reason for overriding. This indicates an urgent need to review and restructure the DDI alert system.ConclusionThe DDI alert override rates are high, and this is undesirable. It is recommended to revise the DDI alert system. Future studies should dig deep for real reasons for overriding and seek inputs from all stakeholders, including developing actionable metrics to track and monitor DDI alerting system.