{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T18:46:44Z","timestamp":1778611604437,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006506","name":"Brazilian Ministry of Health","doi-asserted-by":"crossref","award":["e-SUS PHC Project Stage 6"],"award-info":[{"award-number":["e-SUS PHC Project Stage 6"]}],"id":[{"id":"10.13039\/501100006506","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Finantial code - 001"],"award-info":[{"award-number":["Finantial code - 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["Productivity fellow in technology development and"],"award-info":[{"award-number":["Productivity fellow in technology development and"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Informatics J"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>Primary studies have demonstrated that despite being useful, most of the drug-drug interaction (DDI) alerts generated by clinical decision support systems are overridden by prescribers. To provide more information about this issue, we conducted a systematic review and meta-analysis on the prevalence of DDI alerts generated by CDSS and alert overrides by physicians. The search strategy was implemented by applying the terms and MeSH headings and conducted in the MEDLINE\/PubMed, EMBASE, Web of Science, Scopus, LILACS, and Google Scholar databases. Blinded reviewers screened 1873 records and 86 full studies, and 16 articles were included for analysis. The overall prevalence of alert generated by CDSS was 13% (CI95% 5\u201324%, p-value &lt;0.0001, I^2 = 100%), and the overall prevalence of alert override by physicians was 90% (CI95% 85\u201395%, p-value &lt;0.0001, I^2 = 100%). This systematic review and meta-analysis presents a high rate of alert overrides, even after CDSS adjustments that significantly reduced the number of alerts. After analyzing the articles included in this review, it was clear that the CDSS alerts physicians about potential DDI should be developed with a focus on the user experience, thus increasing their confidence and satisfaction, which may increase patient clinical safety.<\/jats:p>","DOI":"10.1177\/14604582241263242","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T08:09:47Z","timestamp":1718870987000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Override rate of drug-drug interaction alerts in clinical decision support systems: A brief systematic review and meta-analysis"],"prefix":"10.1177","volume":"30","author":[{"given":"Mariano","family":"Felisberto","sequence":"first","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"},{"name":"Department of Clinical Analysis, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Geovana dos Santos","family":"Lima","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"},{"name":"Department of Nursing, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Ianka Cristina","family":"Celuppi","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"},{"name":"Department of Nursing, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Miliane dos Santos","family":"Fantonelli","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Wagner Luiz","family":"Zanotto","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"J\u00falia Meller","family":"Dias de Oliveira","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"},{"name":"Graduate Program in Dentistry, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Eduarda Talita Bramorski","family":"Mohr","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"},{"name":"Department of Clinical Analysis, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Ranieri Alves","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Daniel Henrique","family":"Scandolara","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"C\u00e9lio Luiz","family":"Cunha","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Jades Fernando","family":"Hammes","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"J\u00falia Salvan","family":"da Rosa","sequence":"additional","affiliation":[{"name":"Department of Clinical Analysis, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Izabel Galhardo","family":"Demarchi","sequence":"additional","affiliation":[{"name":"Department of Clinical Analysis, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"given":"Raul Sidnei","family":"Wazlawick","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5220-5396","authenticated-orcid":false,"given":"Eduardo Monguilhott","family":"Dalmarco","sequence":"additional","affiliation":[{"name":"Bridge Laboratory, Technological Center, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"},{"name":"Department of Clinical Analysis, Federal University of Santa Catarina, Florian\u00f3polis, Brazil"}]}],"member":"179","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"key":"bibr1-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019101"},{"key":"bibr2-14604582241263242","doi-asserted-by":"publisher","DOI":"10.17226\/9728"},{"key":"bibr3-14604582241263242","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200730050-00003"},{"key":"bibr4-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkx1037"},{"key":"bibr5-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-022-01783-z"},{"key":"bibr6-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-017-2357-5"},{"key":"bibr7-14604582241263242","doi-asserted-by":"publisher","DOI":"10.3390\/su11082432"},{"key":"bibr8-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzad004"},{"key":"bibr9-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2017.01.009"},{"key":"bibr10-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1714276"},{"key":"bibr11-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.12.1409"},{"key":"bibr12-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-3-56"},{"key":"bibr13-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocw145"},{"key":"bibr14-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2017.12.022"},{"key":"bibr15-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"bibr16-14604582241263242","volume-title":"EndNote X9 computer program","author":"Clarivate Analytics","year":"2021"},{"key":"bibr17-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"bibr18-14604582241263242","unstructured":"Urbaniak GC, Plous S. (2013). Research randomizer (Version 4.0) [Computer software]. Retrieved from: http:\/\/www.randomizer.org\/ (accessed 15 july 2021)."},{"key":"bibr19-14604582241263242","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2020"},{"key":"bibr20-14604582241263242","volume-title":"Critical appraisal tools 2020","author":"Joanna Briggs Institute JBI"},{"key":"bibr21-14604582241263242","doi-asserted-by":"publisher","DOI":"10.4338\/ACI-2013-12-RA-0103"},{"key":"bibr22-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxz012"},{"key":"bibr23-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3400447"},{"key":"bibr24-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa034"},{"key":"bibr25-14604582241263242","doi-asserted-by":"publisher","DOI":"10.4258\/hir.2014.20.4.280"},{"key":"bibr26-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3591"},{"key":"bibr27-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-015-0194-y"},{"key":"bibr28-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2017.08.008"},{"issue":"5","key":"bibr29-14604582241263242","first-page":"289","volume":"16","author":"Zenziper Y","year":"2014","journal-title":"Isr Med Assoc J"},{"key":"bibr30-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-017-0525-4"},{"key":"bibr31-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-012-1241-6"},{"key":"bibr32-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2021.104393"},{"key":"bibr33-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1136\/ejhpharm-2013-000308"},{"key":"bibr34-14604582241263242","doi-asserted-by":"publisher","DOI":"10.14236\/jhi.v20i4.15"},{"key":"bibr35-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-022-03292-4"},{"key":"bibr36-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-022-01838-1"},{"key":"bibr37-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2013.12.006"},{"key":"bibr38-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1080\/14639220500370105"},{"key":"bibr39-14604582241263242","doi-asserted-by":"publisher","DOI":"10.2196\/40511"},{"key":"bibr40-14604582241263242","doi-asserted-by":"publisher","DOI":"10.2196\/15653"},{"key":"bibr41-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2013.02.003"},{"key":"bibr42-14604582241263242","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2021.104506"}],"container-title":["Health Informatics Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14604582241263242","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14604582241263242","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14604582241263242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:28:34Z","timestamp":1777501714000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14604582241263242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":42,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1177\/14604582241263242"],"URL":"https:\/\/doi.org\/10.1177\/14604582241263242","relation":{},"ISSN":["1460-4582","1741-2811"],"issn-type":[{"value":"1460-4582","type":"print"},{"value":"1741-2811","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"article-number":"14604582241263242"}}