Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings: protocol for a systematic review of qualitative studies

Albert Farre, Danai Bem, Karen Shaw, Carole Cummins

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
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Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or Computerized Provider/Physician Order Entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative
approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support (CDS).
Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest, and SCOPUS. In addition, other sources will be
searched for ongoing studies ( and grey literature: HMIC, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by two reviewers. Qualitative studies, either standalone or in the context of mixed methods designs, reporting the perspectives of any actors involved in the implementation,
management and use of ePrescribing/CPOE systems in hospital-based care settings will be included.
Data extraction will be conducted by two reviewers using a piloted form. Quality appraisal will be based on criteria from the CASP and SRQR checklists. Studies will not be excluded based on quality assessment. A post-synthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method.
Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.
Systematic review registration: PROSPERO CRD42016035552.
• Although a number of systematic reviews have been conducted to date on ePrescribing or CPOE systems, only a few have focused on hospital settings.
• According to the scoping searches conducted by the authors, only two existing reviews included qualitative studies, of which, only one focused on providers’ perceptions in a hospital setting.
• To the best of the knowledge of the authors, this is the first systematic review of qualitative evidence relating to the management and use/optimisation of ePrescribing systems in hospital settings, not limited to the implementation process, and including any reported perspectives (i.e. not only health professionals, but also managers, commissioners, patients and relatives/carers).
• The review will not address perceptions and experiences related to non-hospital based settings.
Original languageEnglish
Article numbere011858
JournalBMJ open
Issue number7
Publication statusPublished - 8 Jul 2016


  • Electronic prescribing
  • Computerized Provider Order Entry (CPOE)
  • Systematic Review
  • Qualitative Research
  • Thematic Synthesis


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