BMJ  2004;328:1566 (26 June), doi:10.1136/bmj.328.7455.1566-a

Letter

Computer aided prescribing

Decision support needs to be evidence based

The first 150 words of the full text of this article appear below.

EDITOR—The deficiencies of existing computerised prescribing decision support systems in the United Kingdom described by Fernado et al and Ferner are mirrored in Australia.^{1 2} Focus groups conducted by the Australian national prescribing service highlighted concerns that prescribing decision support prompts may not be evidence based or comprehensive.³

Subsequently, four prescribing packages were analysed, using the drug records of 20 elderly patients (N Sharma et al, Australian health and medical research congress, Melbourne, November 2002). There were 5-22 recommended drug-drug interaction prompts per patient. These interactions had been categorised by experts as clinically important (for example, ergotamine and erythromycin), clinically appropriate (for example, celecoxib, angiotensin converting enzyme inhibitor, and diuretic), or of low clinical importance (for example, tramadol and warfarin). The appropriateness of the information for a prescriber in general practice was also examined.

Large variations in the total number of prompts, clinical relevance, and appropriateness of the information . . . [Full text of this article]

Department of Rural Health, University of Melbourne, Graham Street, Shepparton, VIC 3630, Australia t.liaw@unimelb.edu.au

National Prescribing Service, Australia, Level 7, 418A Elizabeth Street, Surry Hills, NSW 2010, Australia

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