{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:57:12Z","timestamp":1790913432183,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Hypo\u2010 and hyperglycaemia are major issues for hospital inpatients with diabetes, associated with risk of increased adverse outcomes, including higher mortality and prolonged length of stay.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n We investigated whether implementation of a multidisciplinary co\u2010designed, non\u2010interruptive electronic medical record (EMR)\u2010based alert for glycaemia was associated with changes in diabetes medication management in hospital.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was an observational study from September 2022 to January 2023 comparing 7\u2010week pre\u2010intervention and intervention periods separated by a 4\u2010week non\u2010analysis transition. Non\u2010interruptive alerts for hypo\u2010 and hyperglycaemia were deployed through the EMR, which provided management recommendations. The primary outcome was electronic alert acknowledgement. Secondary outcomes included medication changes and adverse glycaemic event recurrence.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During the intervention period, rates of alert acknowledgement were very low (hypoglycaemia 1.0% and hyperglycaemia 0.1%). Following alert implementation there was no significant change in medication modification in response to hypoglycaemia (relative risk (RR) 1.42,\n P<\/jats:italic>\n =\u20090.500) or hyperglycaemia (RR 0.64,\n P<\/jats:italic>\n =\u20090.141) events compared with pre\u2010intervention. There was no significant difference in risk for hypoglycaemia recurrence (RR 1.89,\n P<\/jats:italic>\n =\u20090.443), but the risk for hyperglycaemia recurrence was lower (RR 0.79,\n P<\/jats:italic>\n =\u20090.014) during intervention compared to pre\u2010intervention.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Despite multidisciplinary co\u2010design, education and implementation, non\u2010interruptive alerts for glycaemia were not electronically acknowledged in most cases. The alert did not change medication management and thus was unlikely to be the cause of reduction in recurrence of adverse glycaemic events. Further research is required to determine barriers, to develop strategies to improve user engagement and to optimise glycaemic\u2010based electronic alerts, aiming to assist health professionals working in acute care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/imj.70655","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:44:51Z","timestamp":1790912691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of a co\u2010designed clinical decision support tool for inpatient glycaemia management"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2379-7945","authenticated-orcid":false,"given":"Megan","family":"Dharma","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology The Royal Melbourne Hospital Melbourne Victoria Australia"},{"name":"Department of Medicine The Royal Melbourne Hospital, The University of Melbourne Melbourne Victoria Australia"},{"name":"Australian Centre for Accelerating Diabetes Innovations The University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1433-2239","authenticated-orcid":false,"given":"Rahul D.","family":"Barmanray","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology The Royal Melbourne Hospital Melbourne Victoria Australia"},{"name":"Department of Medicine The Royal Melbourne Hospital, The University of Melbourne Melbourne Victoria Australia"},{"name":"Australian Centre for Accelerating Diabetes Innovations The University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8747-6615","authenticated-orcid":false,"given":"Andrew","family":"Coote","sequence":"additional","affiliation":[{"name":"Electronic Medical Record Team The Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Plumb","sequence":"additional","affiliation":[{"name":"Clinical Informatics Centre The Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4341-8250","authenticated-orcid":false,"given":"Mervyn","family":"Kyi","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology The Royal Melbourne Hospital Melbourne Victoria Australia"},{"name":"Department of Medicine The Royal Melbourne Hospital, The University of Melbourne Melbourne Victoria Australia"},{"name":"Australian Centre for Accelerating Diabetes Innovations The University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5153-8324","authenticated-orcid":false,"given":"Spiros","family":"Fourlanos","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology The Royal Melbourne Hospital Melbourne Victoria Australia"},{"name":"Department of Medicine The Royal Melbourne Hospital, The University of Melbourne Melbourne Victoria Australia"},{"name":"Australian Centre for Accelerating Diabetes Innovations The University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1700-2355","authenticated-orcid":false,"given":"Timothy N.","family":"Fazio","sequence":"additional","affiliation":[{"name":"Department of Medicine The Royal Melbourne Hospital, The University of Melbourne Melbourne Victoria Australia"},{"name":"Electronic Medical Record Team The Royal Melbourne Hospital Melbourne Victoria Australia"},{"name":"Clinical Informatics Centre The Royal Melbourne Hospital Melbourne Victoria Australia"},{"name":"Health Intelligence Unit The Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1111\/imj.15322","article-title":"Longitudinal prevalence of inpatient diabetes mellitus in an Australian hospital across five decades: 1972\u20132019","volume":"51","author":"Wang R","year":"2021","journal-title":"Intern Med J"},{"key":"e_1_2_8_3_1","volume-title":"National Diabetes Inpatient Audit (NaDIA) \u2013 2019","author":"NHS Digital","year":"2020"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"e445","DOI":"10.1111\/dme.12002","article-title":"Hypoglycaemia is associated with increased length of stay and mortality in people with diabetes who are 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