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Abstract Details
An Electronic Decision Support Intervention Reduces Readmissions for Patients With Cirrhosis
Am J Gastroenterol. 2022 Mar 1;117(3):491-494. doi: 10.14309/ajg.0000000000001608.
Jeremy Louissaint1, Katie Grzyb2, Linda Bashaw2, Rima A Mohammad3, Neehar D Parikh1, Elliot B Tapper1
Author information
Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.
Abstract
Introduction: Rifaximin use in combination with lactulose is associated with a decreased risk of overt hepatic encephalopathy (HE).
Methods: We prospectively evaluated the impact of an interruptive electronic medical record alert to indicate rifaximin for patients with cirrhosis and HE on lactulose.
Results: The intervention was associated increased rifaximin utilization, particularly for nongastroenterology and hospitalist services odds ratio 1.20 95% confidence interval (1.09-1.31). For patients with HE, the intervention was associated with a lower readmission risk-adjusted subdistribution hazard ratio 0.63 95% confidence interval (0.48-0.82).
Discussion: An interruptive alert in the electronic ordering system was associated with a lower risk of readmissions.
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