J Am Med Inform Assoc 18:17-23 doi:10.1136/jamia.2010.006130
  • Research and applications

A randomized-controlled trial of computerized alerts to reduce unapproved medication abbreviation use

  1. Rosemary C Polomano5
  1. 1Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2Department of Clinical Effectiveness and Quality Improvement, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  3. 3Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  4. 4Boston University School of Public Health, Boston, Massachusetts, USA
  5. 5University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Jennifer S Myers, Department of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Penn Tower Suite 2009, Philadelphia, PA 19104, USA; jennifer.myers{at}
  • Received 15 December 2009
  • Accepted 3 November 2010
  • Published Online First 3 December 2010


Abbreviation use is a preventable cause of medication errors. The objective of this study was to test whether computerized alerts designed to reduce medication abbreviations and embedded within an electronic progress note program could reduce these abbreviations in the non-computer-assisted handwritten notes of physicians. Fifty-nine physicians were randomized to one of three groups: a forced correction alert group; an auto-correction alert group; or a group that received no alerts. Over time, physicians in all groups significantly reduced their use of these abbreviations in their handwritten notes. Physicians exposed to the forced correction alert showed the greatest reductions in use when compared to controls (p=0.02) and the auto-correction alert group (p=0.0005). Knowledge of unapproved abbreviations was measured before and after the intervention and did not improve (p=0.81). This work demonstrates the effects that alert systems can have on physician behavior in a non-computerized environment and in the absence of knowledge.


  • A portion of this work was presented at the Society of Hospital Medicine National Meeting in San Diego, California in May 2008 and the National Patient Safety Foundation Meeting in Nashville, Tennessee in May 2008.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the University of Pennsylvania IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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