Safer Prescribing Still Elusive

Computerized prescribing systems often warn doctors of potential interactions, but in one recent study this warning delayed crucial treatment. Nearly 2,000 prescribers were included in the study, which focused on alerting them to the dangers of an interaction between the blood-thinner warfarin and the antibiotic trimethoprim-sulfamethoxazole. This combination antimicrobial was once known under the brand names Bactrim or Septra. There is concern that when this medication is taken with warfarin it increases the risk of serious bleeding.
The trouble is that making doctors stop in the middle of writing a prescription and check with a pharmacist can throw a monkey wrench into the system. In this case, some patients did not get crucial medication for up to three days because the prescriber became distracted. The bottom line seems to be that information technology can be helpful but it is not perfect. Serious alerts should be used very sparingly and should encourage instant communication with the pharmacy to ensure safer prescribing.
[Archives of Internal Medicine, Sept.27, 2010]