Abstract
TO THE EDITOR: We read with interest the report of Hatton et al. 1 The finding of numerous overrated interactions in their computerized drug interaction database is consistent with our experience and certainly contributes to alert fatigue. 2 Reducing the number of high-level alerts will reduce alert fatigue. Some hospitals have reduced alerts by simply shutting off entire sections of the drug interaction alert system; however, this practice is risky for both the institution and patients. 3 We believe that modification of drug interaction alerts should be based on careful evaluation of data describing the interaction and an assessment of the risk to patients of the potential interaction. We recently reported the results of our efforts to reassign the severity rating of all interactions classified as major by the software vendor. 4 After reviewing over 15,000 major drug interaction pairs, we reduced the severity ranking of about 60% of the entries.
As Hatton et al. noted, the ability to customize drug interaction alert severity is a desirable feature that should be included in any drug interaction database. We have found that institutions have unique needs when customizing their drug interaction database. Needs assessment followed by knowledgeable evaluation of interactions in the database and a plan for continued database review can produce a drug interaction decision support system that protects patients without excessive practitioner burden.
Footnotes
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