Background: Alert fatigue could potentially be improved if physicians agreed on which alerts were clinically significant. We conducted a study to determine the extent to which physicians agree on which drug-drug interactions are clinically significant.
Methods: Two groups of eight generalist physicians reviewed 100 randomly selected drug-drug interactions from the Medi-Span® Drug Therapy Monitoring System™ database and indicated whether they thought each interaction was clinically significant based on the full-text clinical discussion contained within each interaction monograph and their clinical experience.
Results: The Fleiss Kappa measure of inter-rater agreement was 0.19 (0.12, 0.26) for one group, 0.22 (0.14, 0.29) for the second group and 0.21 (0.15, 0.27) for the combined group.
Conclusion: We found poor agreement among generalist physicians on which drug-drug interactions are clinically significant. Use of a feature to allow physicians to tailor alerts to their needs may be an important component in reducing alert fatigue.
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