Topaz M, Seger DL, Lai K, Wickner PG, Goss F, Dhopeshwarkar N, Chang F, Bates DW, Zhou L. High Override Rate for Opioid Drug-allergy Interaction Alerts: Current Trends and Recommendations for Future.
There are three possible reasons for this high override rate.
The existing CPOE alerts have limited impact, as demonstrated by high override rates similar to the reported literature.
Nevertheless, the findings have important implications for enhancing medication safety and identifying an approach to decrease high override rates.
[ 7– 9] These high override rates imply that either too many alerts are being delivered or providers may be overriding clinically important suggestions.
High override rates for drug-drug interaction (DDI) alerts in electronic health records (EHRs) result in the potentially dangerous consequence of providers ignoring clinically significant alerts.
In other words, physician-level targeted interventions might be helpful to improve high override rates if the physicians can be assured of the importance of the warnings.
Although most outpatients are relatively healthy, many have chronic renal insufficiency, and high override rates for suggestions on renal dosing have been observed.
Especially drug-drug interaction (DDI) and drug-allergy checking suffers from low specificity due to too many false positive warnings which results in high override-rates [ 11, 12].
Studies evaluating the reasons for these high override rates have found that the interactions for which the alerts are generated often lack clinical significance and may also have inadequate literature evidence supporting their validity [ 4- 6].
