Table 4

Factors associated with revising a prescription in response to an alert

Alerts seen=807	Descriptive statistics				Regression analysis*
	Over-ride		Revise		Bivariate			Multivariate
	(n=727)		(n=80)		OR	95% CI	p Value	OR	95% CI	p Value
Alert characteristics
Severity of alert	n	%	n	%
Most severe	264	36	51	64	2.21	1.48 to 3.29	<0.01	2.03	1.39 to 2.98	<0.01
Moderate or less severe	463	64	29	36	Reference	Reference	Reference	Reference	Reference	Reference
Type of alert
Drug–age contraindication	263	36	30	38	Ref	Ref	Ref	Ref	Ref	Ref
Cumulative side effects	104	14	8	10	0.97	0.73 to 1.30	0.86	1.06	0.70 to 1.60	0.79
Drug–disease contraindication	128	18	16	20	0.94	0.64 to 1.38	0.75	0.74	0.44 to 1.23	0.24
Therapy duplication	94	13	8	10	0.97	0.57 to 1.67	0.92	1.14	0.47 to 2.79	0.77
Drug interaction	42	6	1	1	0.67	0.49 to 0.93	0.02	0.49	0.22 to 1.08	0.08
Excess dose	75	10	13	16	0.98	0.50 to 1.92	0.95	0.67	0.34 to 1.34	0.26
Renal dose adjustment	10	1	2	3	1.55	1.07 to 2.25	0.02	1.64	1.09 to 2.46	0.02
Drug or potential cross allergy	8	1	1	1	0.93	0.49 to 1.74	0.81	0.66	0.37 to 1.19	0.17
Other	3	1	1	1	1.42	0.67 to 3.02	0.36	1.41	0.80 to 2.49	0.24
Patient characteristics
Female	475	65	50	63	1.02	0.70 to 1.47	.94	–	–	–
Male	252	35	30	38	Ref	Ref	Ref
	Mean	SD	Mean	SD
Age (years)	74.5	6.2	74.5	6.5	1.02	0.99 to 1.04	0.25	–	–	–
Risk factors for fall-related injuries	n	%	n	%
Fall-related Injury	32	4.4	5	6.3	0.89	0.35 to 2.26	0.80	–	–	–
Gait and balance problems	212	29.2	29	36.3	1.18	0.78 to 1.78	0.44	–	–	–
Lower extremity weakness	61	8.4	7	8.8	1.31	0.68 to 2.51	0.42	–	–	–
Cognitive impairment	103	14.2	12	15	1.67	1.03 to 2.70	0.04	1.95	1.13 to 3.36	0.02
Number of ambulatory visits (year prior to visit) (OR per 5 visit increase)	16.2	23.2	18.6	34.1	1.02	0.99 to 1.06	0.19	1.05	1.004 to 1.09	0.03
Number of active medications (at visit)	10.8	4.9	10.9	4.8	1.01	0.97 to 1.06	0.52
Physician characteristics
Demographic characteristics:	n	%	n	%
Female	119	16	25	31	1.63	0.73 to 3.65	0.23	–	–	–
Male	608	84	55	69	Reference	Reference	Reference
	Mean	SD	Mean	SD
Practice experience (OR per 5 year increase)	24.2	5.4	24.7	6.7	0.96	0.60 to 1.55	0.88	–	–	–
Practice Characteristics
Daily practice volume (OR per 5 patient increase)	20.4	6.1	19.3	6.8	088	0.65 to 1.02	0.38	–	–	–
Percentage of patients 65 years and older (OR per 10% increase)	19.5	9.1	19	8.3	0.83	0.44 to 1.56	0.56	–	–	–
Experience and skills related to electronic prescribing
Electronic prescription speed (minutes per 3 e-RXs) (per minute increase)	5.5	1.6	5.8	1.8	1.18	0.90 to 1.55	0.23	–	–	–
Electronic prescription rate (e-RXs per 100 visits) (per 10 e-RX increase)	31.4	12.4	28.8	15.9	0.84	0.65 to 1.10	0.20	0.86	0.66 to 1.13	0.27
Alert level setting	n	%	n	%
View severe alerts only	323	44.4	48	60	1.80	0.91 to 3.57	0.09	1.11	0.54 to 2.28	0.78
View serious and severe alerts only, or view all alerts	404	55.6	32	40	Reference	Reference	Reference	Reference	Reference	Reference

*The above dataset contained 807 alerts clustered within 303 patients, who were clustered within 47 physicians. For patients clustered within physicians, minimum to maximum cluster size was 1 to 141, respectively. Alternating logistic regression was used to account for two levels of clustering (alerts within patients; patients within physicians).