JMIR Publications

ABSTRACT

Background:

: The consistency and quality of care in modern primary care is supported by a range of clinical reminders (CRs) consisting of ‘alerts’ describing the consequences of certain decisions, and ‘prompts’ that remind the user to perform a task that promotes desirable clinical behaviours. Not all are acted upon, and GPs are disregarding many, a chronic negligence commonly referred to as ‘alert fatigue’.

Objective:

This systematic review explores the interacting influences of deployment, design, and perceived efficacy on alert fatigue in GPs.

Methods:

A systematic literature search was conducted of the HTA database, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, Conference Proceedings Citation Index, PsycINFO and OpenGrey. The search was confined to primary research conducted in general or family practice and exploring GPs’ experience with CRs. All databases were searched from inception to 31st December 2023.

Results:

CRs were viewed as a capable way of maintaining or improving safe and high-quality care. Influences on GP perceptions of CRs’ efficacy were directly linked to their frequency, the presentation and accuracy of the content, and their organisations’ IT infrastructure. GPs expressed concerns over the accuracy of algorithm driven CRs and felt they should be involved in their development and better trained in their use and utility.

Conclusions:

Used optimally CRs can enhance patient safety and quality of care. Recommendations for the future design and implementation of CRs include improved graphical design coupled with more applicable content, and earlier and more consistent engagement with the workforce in their design.