Computerized physician order entry: a key instrument for reducing drug-related problems in hospitals

Objective: To evaluate the effect of the implementation of computerized physician order entry (CPOE) in a clinical unit on drug related problems (DRP) and on the degree of acceptance of the pharmaceutical interventions. Methods: In this prospective, quasi-experimental study, the drug prescriptions of an internal medicine service were revised over two sequential periods of 3.5 months each (before and after the implementation of the CPOE). All the DRP detected in both phases were recorded. The acceptance of the pharmaceutical intervention in each error was also analysed. Results: In the 7 months of the study, a total of 4,023 DRP were detected, 3,785 in the manual prescription (MP) phase and 238 in the CPOE phase, the rate of DRP per patient admitted being 16.9 in MP and 1.07 in CPOE. This constitutes a statistically signifi cant reduction of 93.67%. If we omit the DRP in the identifi cation of the physician's order, we obtain a reduction of 43.21%. With the introduction of CPOE, the DRP in the identifi cation of the physician's order and of transcription in the pharmacy disappeared, those pertaining to unsuitable dose and unsuitable duration and interactions fell, and those involving an error in the identifi cation of the medicinal product increased. Conclusions: The implementation of the CPOE signifi cantly reduced the total rate of DRP and the rate of DRP of major importance. The proportion of pharmaceutical interventions unanswered by the physician has been reduced signifi cantly.