An Electronic Decision Support Intervention Reduces Readmissions for Patients With Cirrhosis.

Abstract

Rifaximin use in combination with lactulose is associated with a decreased risk of overt hepatic encephalopathy (HE). We prospectively evaluated the impact of an interruptive electronic medical record alert to indicate rifaximin for patients with cirrhosis and HE on lactulose. 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). An interruptive alert in the electronic ordering system was associated with a lower risk of readmissions.