GPs' views on computerized drug interaction alerts: questionnaire survey

Background: There is evidence that patients are being prescribed potentially hazardous drug-drug combinations in general practice despite the use of computerized drug interaction alert systems. One reason for this may be that general practitioners (GPs) are overriding these alerts without properly checking them. Aims: (i) To assess GPs views on the relevance of information provided by alert systems; (ii) To determine the proportion of GPs that admit to frequently overriding interaction alerts without properly checking them and (iii) To explore factors that might be associated with a tendency to override alerts. Methods: Questionnaire survey of GPs in four primary care trusts in the Nottingham area of the UK. Results: The response rate was 70% (236 of 336) and detailed analysis was conducted on the 220 respondents who had drug interaction alert systems on their practice computers. Of these, 22% (49 of 220) admitted to frequently or very frequently overriding drug interaction alerts without properly checking them. Potential reasons for overriding alerts included the perception that the alerts were frequently irrelevant. Nevertheless 90% (198 of 219) agreed that it should be more difficult to override alerts for potentially lethal drug combinations. Logistic regression analysis showed that users of the EMIS (Egton Medical Information Systems) computer system were much less likely to admit to overriding alerts without properly checking them than users of other computer systems. Conclusion: A minority of GPs admit to frequently overriding their drug interaction alert systems without properly checking them. The type of computer system used by GPs may make it more or less likely that they override alerts.