The Impact of Computerized Physician Order Entry (CPOE) Combined with Clinical Decision Support System (CDSS) On Preventing Adverse Drug Reactions In Renal Insufficiency: Systematic Review

Abstract

Background: Renal impairment influences a wide range of interventions, and improper actions may lead to many life-threatening complications. The kidney is one of the most important organs for the metabolism of medications. Adverse drug reactions in renal dysfunctional patients are often overlooked when prescribing medications. Implementing innovative technologies such as Computerized Physician Order Entry (CPOE) and Clinical Decision Support System (CDSS) may alleviate these concerns. This study aims to clarify the impact of implementing CDSS and CPOE technology into the healthcare system environment and preventing ADR in patients suffering from renal insufficiency and diseases by systematically reviewing the literature.

Methods: Systematic review was conducted using proper article appraisal, study selection, and results synthesis.

Results: We identified 5 out of 168 articles and were included in this review, following appraisal and PRISMA workflow. 2 studies were RCT, 1 quasi-experimental, 1 retrospective, and 1 alternating time-series. 3 studies focused on nephrotoxic medication adjustment in renal impaired patients. 1 study explored the impact of the various CDSS level of sophistication on renal patients. 1 study shed light on the overdosing of ER physicians for renal impaired patients and the impact of implementing a CDSS for better patient’s safety.

Conclusion: CPOE coupled with CDSS demonstrated an overall positive impact on the quality of care for patients suffering from renal impairment by detecting possible adverse drug reactions. Further, quality research is needed to truly evaluate the impact of CPOE and CDSS in the healthcare domain.