Table 1.

Articles Included in Review.

Reference	Application	Study design	Country	Study focus	Results
Neubauer et al3	CPOE/CDS	Noncontrolled intervention	Austria	Mobile CDS for glycemic management of inpatients with type 2 diabetes mellitus	Insulin adherence improved and providers felt that CDS prevented medication errors
Faine et al4	CPOE/CDS	Pre/postintervention	USA	CPOE-based CDS for appropriate vancomycin dosing	CDS increased weight-based doses, but it was not statistically significant
Lee et al5	CPOE/CDS	Pre/postintervention	Republic of Korea	High-alert medication clinical decision support system on order entry errors	CDS significantly reduced omitted fluids and excessive doses
Galanter et al6	CPOE/CDS	Observational	USA	Prevention of sound-similar medication orders with “indication missing” CDS	Errors were reduced, but the impact of the CDS depended on the medication
Vermeulen et al7	CPOE/CDS	Economic evaluation	The Netherlands	Cost of reducing adverse drug events	CDS costs more than a paper method, but the costs for reducing errors are acceptable
Micek et al8	CPOE/CDS	Controlled intervention	USA	Mobile CDS to reduce inappropriate antibiotic therapy of serious health care–associated infections	The CDS resulted in more inappropriate initial therapy than the nonalert group
Armada et al9	CPOE/CDS	Pre/postintervention	Spain	Evaluate the effects of a CPOE system with CDS in detecting prescription errors	The system was successful in reducing prescription errors in a cardiac intensive care unit setting
Hackl et al10	CPOE/CDS	Controlled series analysis	Austria	Investigate the usage and acceptance of ADE scorecards by health care professionals and their impact on rates of possible ADEs	Scorecards may raise provider awareness of ADEs but not decrease the occurrence
Falck et al11	CPOE/CDS	Observational	USA	Measure the accuracy and completeness of electronic problem list additions using indication-based prescribing of antihypertensives	Indication-based prescribing produced accurate problem placement
Abramson et al12	CPOE/CDS	Mixed-methods cross-sectional case study	USA	Assess the rates and types of errors after transition to CPOE with CDS	Commercial CPOE with CDS reduced errors, but alert firings need to be managed carefully
Galanter et al13	CPOE/CDS	Observational	USA	Determine whether indication-based computer order entry alerts intercept wrong-patient medication errors	Indication-based ordering can identify wrong-patient errors
Pruszydlo et al14	CPOE/CDS	Intervention	Germany	Evaluate a CDS system for drug substitutions	CDS was able to automatically switch ~92% of medications
Maat et al15	CPOE/CDS	Pre/postintervention	The Netherlands	Evaluation of the impact of a CPOE with CDS for glucose control in neonatal intensive care patients	CPOE with CDS had no impact on hypo- or hyperglycemia
Chapman et al16	CPOE/CDS	Pre/postintervention	USA	Determine the impact of CPOE on workflow in the neonatal intensive care unit	Order verification time improved, but administration times did not
Milani et al17	CPOE/CDS	Controlled trial	USA	Evaluate CPOE with CDS on the frequency of antithrombotic medication errors and in-hospital bleeding in patients with chronic kidney disease admitted with acute coronary syndrome	CPOE with CDS may be effective in improving patient safety
Wetterneck et al18	CPOE/CDS	Pre/postintervention	USA	Evaluate the incidence of duplicate medication orders before and after CPOE with CDS implementation	CPOE implementation increased duplicate medication orders
Roberts et al19	CPOE/CDS	Observational	USA	CPOE with advanced CDS on the identification of potential ADEs at medication ordering stage was studied	More potential ADEs were identified, but many were false positives
Kazemi et al20	CPOE/CDS	Observational	Iran	Evaluate effect CPOE and CDS in reducing medication dosing errors	Including CDS reduced errors beyond CPOE without CDS
Terrell et al21	CPOE/CDS	Randomized controlled trial	USA	Evaluate CDS to reduce the rate of excessive medication dosing for patients with renal impairment	CDS reduces excessive doses for patients with lower creatinine clearance
Seidling et al22	CPOE/CDS	Pre/postintervention	Germany	CDS providing upper dose limits personalized to individual patient characteristics	Excessive doses were significantly reduced
Chen et al23	CPOE/CDS	Controlled trial	Taiwan	Hyperlipidemia treatment guidelines in a CDS	CDS improved percentage of patients reaching low-density lipoprotein cholesterol goals
Kadmon et al24	CPOE/CDS	Observational	Israel	Decrease in prescription errors and ADEs using a CPOE with CDS	Pediatric intensive care unit errors and potential ADEs were reduced with CDS use
Terrell et al25	CPOE/CDS	Randomized controlled trial	USA	Evaluate CDS to reduce potentially inappropriate prescribing to older adults	CDS with alternative medications can reduce potentially inappropriate prescribing
Galanter et al26	CPOE/CDS	Observational	USA	Evaluate alerts to add a diagnosis to the problem list	CDS led to more correct problems being added to problem lists
Turchin et al27	CPOE/CDS	Cross-sectional survey	USA	Evaluate inpatient computerized medication reconciliation system	Users valued the system but wanted tighter integration
Mahoney et al28	CPOE/CDS	Pre/postintervention	USA	Evaluate the impact of CPOE with CDS on medication errors throughout the medication use process	Implementation reduced errors through the process and for specific patient populations
Vardi et al29	CPOE/CDS	Observational	Israel	Evaluate the impact of a CPOE/CDS on the frequency of errors in ordering and form completion time	There was a 100% reduction in errors and time required was significantly reduced
Abboud et al30	CPOE/CDS	Pre/postintervention	USA	Examine a CDS for pediatric aminoglycoside laboratory monitoring	CDS did not significantly increase laboratory monitoring
Eslami et al31	CPOE/CDS	Observational	The Netherlands	Investigate the effects of a CPOE/CDS system with initial default dose on the frequency of medication errors and potential ADEs	More initial doses followed the CDS recommendation, but the recommendation is too high for patients with renal insufficiency
Cornu et al32	Alerts	Pre/postintervention	Belgium	Evaluate context-specific drug-drug interaction alerting system on alert acceptance	Redesigned alerts with context-specific information improved alert acceptance
Stultz et al33	Alerts	Observational	USA	Determine the sensitivity and specificity of an alert system for dosing errors	Customization of alerts improves sensitivity and specificity of alerts
Woods et al34	Alerts	Pre/postintervention	USA	Detection and warning of atypical medication orders	Historical data can improve specificity of alerts
Boussadi et al35	Alerts	Observational	France	Assess the diagnostic performance of an alert system for renally cleared drug dosing control	Alerts captured more issues and had fewer errors than pharmacists reviewing medication orders
Myers et al36	Alerts	Randomized controlled trial	USA	Assess computerized alerts designed to reduce medication abbreviations could reduce abbreviations in physician handwritten notes	Knowledge of abbreviations did not improve, but providers with forced correction of abbreviations in computerized notes had the greatest reduction in handwritten abbreviation use
Strom et al37	Alerts	Randomized controlled trial	USA	Evaluate the effectiveness of a nearly hard-stop alert for drug interactions	Hard-stop alerts can be effective in changing prescribing, but can lead to delays in care
Turchin et al38	Alerts	Pseudo-randomized controlled trial	USA	Determine whether interruptive alerts will increase utilization of several functionalities	Alerts doubled the use of promoted functionalities
Strom et al39	Alerts	Randomized controlled trial	USA	Evaluate the incremental effectiveness of an alert that required a response from the provider	Requiring a provider response did not improve desired ordering
Hamad et al40	Calculator	Pre/postintervention	UK	Evaluate impact of online dose calculators on initial dose accuracy	Calculators significantly improved initial antibiotic dosing
Dingley et al41	Calculator	Randomized controlled trial	UK	Evaluate calculation of fluid requirements in pediatric burns	An electronic calculator produced fewer calculation errors than other methods

Abbreviations: ADE, adverse drug event; CDS, clinical decision support; CPOE, computerized provider order entry.