Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 22;31(1):231-239.
doi: 10.1093/jamia/ocad208.

Clinical decision support systems in community pharmacies: a scoping review

Affiliations

Clinical decision support systems in community pharmacies: a scoping review

Jukrin Moon et al. J Am Med Inform Assoc. .

Abstract

Objective: Clinical decision support systems (CDSS) were implemented in community pharmacies over 40 years ago. However, unlike CDSS studies in other health settings, few studies have been undertaken to evaluate and improve their use in community pharmacies, where billions of prescriptions are filled every year. The aim of this scoping review is to summarize what research has been done surrounding CDSS in community pharmacies and call for rigorous research in this area.

Materials and methods: Six databases were searched using a combination of controlled vocabulary and keywords relating to community pharmacy and CDSS. After deduplicating the initial search results, 2 independent reviewers conducted title/abstract screening and full-text review. Then, the selected studies were synthesized in terms of investigational/clinical focuses.

Results: The selected 21 studies investigated the perception of and response to CDSS alerts (n = 7), the impact of CDSS alerts (n = 7), and drug-drug interaction (DDI) alerts (n = 8). Three causes of the failures to prevent DDIs of clinical importance have been noted: the perception of and response to a high volume of DDI alerts, a suboptimal performance of CDSS, and a dearth of sociotechnical considerations for managing workload and workflow. Additionally, 7 studies emphasized the importance of utilizing CDSS for a specific clinical focus, ie, antibiotics, diabetes, opioids, and vaccinations.

Conclusion: Despite the range of topics dealt in the last 30 years, this scoping review confirms that research on CDSS in community pharmacies is limited and disjointed, lacking a comprehensive approach to highlight areas for improvement and ways to optimize CDSS utilization.

Keywords: alert; clinical decision support; community pharmacy; drug utilization review; drug–drug interaction.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Literature search and selection process using the PRISMA flow diagram.

References

    1. Sutton RT, Pincock D, Baumgart DC, Sadowski DC, Fedorak RN, Kroeker KI.. An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ Digit Med. 2020;3:17. 10.1038/s41746-020-0221-y - DOI - PMC - PubMed
    1. U.S. Congress. H.R.5835—101st Congress (1989-1990): Omnibus Budget Reconciliation Act of 1990. Published November 5, 1990. Accessed April 4, 2023. http://www.congress.gov/
    1. Middleton B, Sittig DF, Wright A.. Clinical decision support: a 25 year retrospective and a 25 year vision. Yearb Med Inform. 2016;Suppl 1(Suppl 1):S103-S116. 10.15265/IYS-2016-s034 - DOI - PMC - PubMed
    1. Wasylewicz ATM, Scheepers-Hoeks AMJW.. Clinical decision support systems. In: Kubben P, Dumontier M, Dekker A, eds. Fundamentals of Clinical Data Science. Springer; 2019:153–169. Accessed April 19, 2023. http://www.ncbi.nlm.nih.gov/books/NBK543516/ - PubMed
    1. Academy of Managed Care Pharmacy. Drug Utilization Review | AMCP.org. Published April 4, 2023. Accessed April 4, 2023. https://www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-ca...

Publication types