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To the Editor: The study by Dr Alexander and colleagues¹ on excess dosing of antiplatelet and antithrombin agents provides critical information on the nature, magnitude, and consequences of an important issue. Given the widespread interest in using electronic medical records and decision support tools to promote accurate prescribing of medications, we are interested in whether the authors explored such relationships in their analyses and whether the presence or absence of electronic medical records was associated with inappropriate dosing.^2-3 Although computerized order entry may minimize some errors, other errors may be generated, demonstrating the need to critically evaluate all approaches.^4-5

Financial Disclosures: None reported.

David Parra, PharmD
david.parra@med.va.gov

Daniel Woods, MD; Venkataraman Balu, MD
Department of Cardiology

Roy Coakley, MS
Department of Clinical Pharmacy
Veterans Affairs Medical Center
West Palm Beach, Fla

1. Alexander KP, Chen AY, Roe MT, et al, CRUSADE Investigators. Excess dosing of antiplatelet and antithrombin agents in the treatment of non–ST-segment elevation acute coronary syndromes. JAMA. 2005;294:3108-3116. FREE FULL TEXT 2. Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280:1311-1316. FREE FULL TEXT 3. Bates DW, Gawande AA. Patient safety: improving safety with information technology. N Engl J Med. 2003;348:2526-2534. FREE FULL TEXT 4. Teich JM, Merchia PR, Schmiz JL, et al. Effects of computerized physician order entry on prescribing practices. Arch Intern Med. 2000;160:2741-2747. FREE FULL TEXT 5. Koppel R, Metlay JP, Cohen A, et al. Role of computerized physician order entry systems in facilitating medication errors. JAMA. 2005;293:1197-1203. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295:1897.

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