scholarly journals Reducing Inappropriate Drug Use in Older Patients by Use of Clinical Decision Support in Community Pharmacy: A Mixed-Methods Evaluation

Drugs & Aging ◽  
2019 ◽  
Vol 37 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Linda G. M. Mulder-Wildemors ◽  
Mette Heringa ◽  
Annemieke Floor-Schreudering ◽  
Paul A. F. Jansen ◽  
Marcel L. Bouvy
Keyword(s):  
Decision Support ◽  
Mixed Methods ◽  
Drug Use ◽  
Community Pharmacy ◽  
Clinical Decision Support ◽  
Older Patients ◽  
Clinical Decision ◽  
Inappropriate Drug ◽  
Mixed Methods Evaluation ◽  
Inappropriate Drug Use

scholarly journals GRP-107 Is Weakness in Older Patients Caused by Inappropriate Drug Use?

2013 ◽  
Vol 20 (Suppl 1) ◽  
pp. A39.1-A39 ◽  
Author(s):  
LD Jensen ◽  
M Hallin ◽  
O Andersen ◽  
J Petersen
Keyword(s):  
Drug Use ◽  
Older Patients ◽  
Inappropriate Drug ◽  
Inappropriate Drug Use

Exploring the early phase of implementation of a vaccine-based clinical decision support system in the community pharmacy

2020 ◽  
Vol 60 (6) ◽  
pp. e292-e300
Author(s):  
Kelsey D. Frederick ◽  
Justin D. Gatwood ◽  
Daniel R. Atchley ◽  
Leanne J. Rein ◽  
Suzan G. Ali ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Community Pharmacy ◽  
Clinical Decision Support ◽  
Support System ◽  
Early Phase ◽  
Clinical Decision Support System ◽  
Clinical Decision

scholarly journals Effect of Interventions With a Clinical Decision Support System for Hospitalized Older Patients: Systematic Review Mapping Implementation and Design Factors

10.2196/28023 ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. e28023
Author(s):  
Birgit A Damoiseaux-Volman ◽  
Nathalie van der Velde ◽  
Sil G Ruige ◽  
Johannes A Romijn ◽  
Ameen Abu-Hanna ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Older Patients ◽  
Clinical Decision ◽  
Risk Of Bias ◽  
Hospitalized Patients ◽  
Effective Interventions ◽  
Design Factors ◽  
Implementation Factors

Background Clinical decision support systems (CDSSs) form an implementation strategy that can facilitate and support health care professionals in the care of older hospitalized patients. Objective Our study aims to systematically review the effects of CDSS interventions in older hospitalized patients. As a secondary aim, we aim to summarize the implementation and design factors described in effective and ineffective interventions and identify gaps in the current literature. Methods We conducted a systematic review with a search strategy combining the categories older patients, geriatric topic, hospital, CDSS, and intervention in the databases MEDLINE, Embase, and SCOPUS. We included controlled studies, extracted data of all reported outcomes, and potentially beneficial design and implementation factors. We structured these factors using the Grol and Wensing Implementation of Change model, the GUIDES (Guideline Implementation with Decision Support) checklist, and the two-stream model. The risk of bias of the included studies was assessed using the Cochrane Collaboration’s Effective Practice and Organisation of Care risk of bias approach. Results Our systematic review included 18 interventions, of which 13 (72%) were effective in improving care. Among these interventions, 8 (6 effective) focused on medication review, 8 (6 effective) on delirium, 7 (4 effective) on falls, 5 (4 effective) on functional decline, 4 (3 effective) on discharge or aftercare, and 2 (0 effective) on pressure ulcers. In 77% (10/13) effective interventions, the effect was based on process-related outcomes, in 15% (2/13) interventions on both process- and patient-related outcomes, and in 8% (1/13) interventions on patient-related outcomes. The following implementation and design factors were potentially associated with effectiveness: a priori problem or performance analyses (described in 9/13, 69% effective vs 0/5, 0% ineffective interventions), multifaceted interventions (8/13, 62% vs 1/5, 20%), and consideration of the workflow (9/13, 69% vs 1/5, 20%). Conclusions CDSS interventions can improve the hospital care of older patients, mostly on process-related outcomes. We identified 2 implementation factors and 1 design factor that were reported more frequently in articles on effective interventions. More studies with strong designs are needed to measure the effect of CDSS on relevant patient-related outcomes, investigate personalized (data-driven) interventions, and quantify the impact of implementation and design factors on CDSS effectiveness. Trial Registration PROSPERO (International Prospective Register of Systematic Reviews): CRD42019124470; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=124470.

scholarly journals Frequency and Acceptance of Clinical Decision Support System-Generated STOPP/START Signals for Hospitalised Older Patients with Polypharmacy and Multimorbidity

Drugs & Aging ◽  
2021 ◽  
Author(s):  
Bastiaan T. G. M. Sallevelt ◽  
Corlina J. A. Huibers ◽  
Jody M. J. Op Heij ◽  
Toine C. G. Egberts ◽  
Eugène P. van Puijenbroek ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Older Patients ◽  
Clinical Decision

scholarly journals Examining perceptions of the usefulness and usability of a mobile-based system for pharmacogenomics clinical decision support: a mixed methods study

2015 ◽  
Author(s):  
Kathrin Blagec ◽  
Katrina M Romagnoli ◽  
Richard D Boyce ◽  
Matthias Samwald
Keyword(s):  
Decision Support ◽  
Mixed Methods ◽  
Clinical Decision Support ◽  
Data Privacy ◽  
Qualitative Interviews ◽  
Cost Benefit ◽  
Clinical Decision ◽  
Patient Specific ◽  
Clinical Implementation ◽  
Hypothetical Patient

Background. Pharmacogenomic testing has the potential to improve the safety and efficacy of pharmacotherapy, but clinical application of pharmacogenetic knowledge has remained uncommon. Clinical decision support (CDS) systems could help overcome some of the barriers to clinical implementation. The aim of this study was to evaluate the perception and usability of a web- and mobile-enabled CDS system for pharmacogenetics-guided drug therapy – the Medication Safety Code (MSC) system – among potential users (i.e., physicians and pharmacists). Furthermore, this study sought to collect data on the practicability and comprehensibility of potential layouts of a proposed personalized pocket card that is intended to not only contain the machine-readable data for use with the MSC system but also human-readable data on the patient’s pharmacogenomic profile. Methods. We deployed an emergent mixed methods design encompassing (1) qualitative interviews with pharmacists and pharmacy students, (2) a survey among pharmacogenomics experts that included both qualitative and quantitative elements and (3) a quantitative survey among physicians and pharmacists. The interviews followed a semi-structured guide including a hypothetical patient scenario that had to be solved by using the MSC system. The survey among pharmacogenomics experts focused on what information should be printed on the card and how this information should be arranged. Furthermore, the MSC system was evaluated based on two hypothetical patient scenarios and four follow-up questions on the perceived usability. The second survey assessed physicians’ and pharmacists’ attitude towards the MSC system. Results. In total, 101 physicians, pharmacists and PGx experts coming from various relevant fields evaluated the MSC system. Overall, the reaction to the MSC system was positive across all investigated parameters and among all user groups. The majority of participants were able to solve the patient scenarios based on the recommendations displayed on the MSC interface. A frequent request among participants was to provide specific listings of alternative drugs and concrete dosage instructions. Negligence of other patient-specific factors for choosing the right treatment such as renal function and co-medication was a common concern related to the MSC system, while data privacy and cost-benefit considerations emerged as the participants’ major concerns regarding pharmacogenetic testing in general. The results of the card layout evaluation indicate that a gene-centered and tabulated presentation of the patient’s pharmacogenomic profile is helpful and well-accepted. Conclusions. We found that the MSC system was well-received among the physicians and pharmacists included in this study. A personalized pocket card that lists a patient's metabolizer status along with critically affected drugs can alert physicians and pharmacists to the availability of essential therapy modifications.

Priority Setting in Improving Hospital Care for Older Patients Using Clinical Decision Support

2019 ◽  
Vol 20 (8) ◽  
pp. 1045-1047
Author(s):  
Birgit A. Damoiseaux-Volman ◽  
Stephanie Medlock ◽  
Kim J. Ploegmakers ◽  
Fatma Karapinar-Çarkit ◽  
C.T. Paul Krediet ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Priority Setting ◽  
Older Patients ◽  
Hospital Care ◽  
Clinical Decision

Clinical Decision Support Intervention and Time to Imaging in Older Patients with Traumatic Brain Injury

2020 ◽  
Vol 231 (3) ◽  
pp. 361-367.e2
Author(s):  
Arthur S. Nguyen ◽  
Simon Yang ◽  
Brian V. Thielen ◽  
Kristina Techar ◽  
Regina M. Lorenzo ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Decision Support ◽  
Brain Injury ◽  
Clinical Decision Support ◽  
Older Patients ◽  
Clinical Decision ◽  
Support Intervention ◽  
Decision Support Intervention
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