{
  "abstract": "Background and importance Patient safety is paramount and hospitalised patients are particularly susceptible to adverse drug events (ADEs), including medication errors (MEs). The high rate of MEs in hospitals is a significant and well-recognised problem. Strategies to reduce MEs have the potential to substantially reduce ADEs and improve patient safety. One such strategy is the implementation of Clinical Decision Support Systems (CDSSs).Aim and objectives To review the impact of CDSS within electronic prescribing (EP) on reducing MEs, ADEs, and/or improving other patient outcomes in hospital setting, to have an overview of CDSS impact on safety, and to identify where their implementation may be most relevant and evidence needs.Material and methods A scoping review was conducted in accordance with PRISMA-Scr guidelines. Searches were performed in Medline (PubMed), Cochrane Trials, and Cochrane Reviews up to March 2024. Studies were selected based on a PICO framework and their quality was assessed using the Joanna Briggs Institute tools.Results Forty-three studies were included from the 2,425 records identified and categorised into seven areas. Six of the 43 studies were randomised controlled trials (RCT). Thirty-two studies were of high quality in their category.Of the 12 studies evaluating ADEs, seven reported statistically significant reductions, especially those related to anti-infective therapy or paediatrics. Forty studies analysed MEs, and all reported statistically significant reductions. These were particularly relevant anti-infective prescribing (CDSS increased appropriate antibiotic selection, dose and duration, among others), in the elderly (a decrease in potentially inappropriate medication was observed in all articles), in paediatrics (the dosing error rate was reduced by half or more), and in targeted medications (doses exceeding the daily limit of five high-alert medications and inappropriate haloperidol prescriptions for high-risk patients decreased, and electrolyte supplementation in patients with recently reported hypokalaemia and hypomagnesaemia increased).Nineteen studies evaluated other outcomes, eg, length of stay, mortality, and readmission rates, with mixed or non-significant results.Conclusion and Relevance Published evidence supports that CDSS integrated into EP are effective in improving patient safety by reducing MEs and ADEs, especially those related to antimicrobials and in elderly or paediatric patients. Evidence on other patient outcomes remains less robust. Further RCT are needed to validate these findings.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Clínica Universidad De Navarra, Pharmacy, Navarra, Spain"
      ],
      "name": "E Molins Castiella"
    },
    {
      "affiliations": [
        "Clínica Universidad De Navarra, Pharmacy, Navarra, Spain"
      ],
      "name": "I Aquerreta Gonzalez"
    },
    {
      "affiliations": [
        "Clínica Universidad De Navarra, Pharmacy, Navarra, Spain"
      ],
      "name": "E Blazquiz Ibero"
    },
    {
      "affiliations": [
        "Clínica Universidad De Navarra, Pharmacy, Navarra, Spain"
      ],
      "name": "S Berisa Prado"
    },
    {
      "affiliations": [
        "Clínica Universidad De Navarra, Pharmacy, Navarra, Spain"
      ],
      "name": "A Ortega Eslava"
    }
  ],
  "title": "5PSQ-156 Impact of hospital clinical decision support systems on medication errors, adverse drug events or other patient outcomes. A scoping review",
  "uid": "53940dfb-e76a-5763-a61c-6e130c611b14"
}