An Electronic Decision Support Intervention Reduces Readmissions for Patients with Cirrhosis

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.