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.

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.

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

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1671 ◽  
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.

Building an information system to facilitate pharmacogenomics clinical translation with clinical decision support

2021 ◽  
Author(s):  
Weifeng Qin ◽  
Xudong Lu ◽  
Qiang Shu ◽  
Huilong Duan ◽  
Haomin Li
Keyword(s):  
Information System ◽  
Decision Support ◽  
Electronic Health Record ◽  
Precision Medicine ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Clinical Translation ◽  
Health Record ◽  
Clinical Implementation ◽  
Novel Approach

Pharmacogenomics clinical decision support (PGx-CDS) is an important tool to incorporate PGx information into existing clinical workflows and facilitate PGx clinical translation. However, due to the lack of a computable formalization to represent the primary PGx knowledge, the complexity of genomics information and the lag of current commercial electronic health record (EHR) system for precision medicine, it is difficult to develop computerized PGx-CDS. Therefore, we explored a novel approach to build an information system, named the Pharmacogenomics Clinical Translation Platform (PCTP), for PGx clinical implementation. The PCTP can represent, store, and manage the primary PGx knowledge in a structured and computable format. Moreover, it has the potential to provide various PGx-CDS services and simplify the integration of PGx-CDS into EHRs.

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 Clinical implementation of pharmacogenomics via a health system-wide research biobank: the University of Colorado experience

2020 ◽  
Vol 21 (6) ◽  
pp. 375-386 ◽  
Author(s):  
Christina L Aquilante ◽  
David P Kao ◽  
Katy E Trinkley ◽  
Chen-Tan Lin ◽  
Kristy R Crooks ◽  
...  
Keyword(s):  
Decision Support ◽  
Health System ◽  
Clinical Decision Support ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Clinical Implementation ◽  
Support Tool ◽  
University Of Colorado ◽  
The University ◽  
The Impact

In recent years, the genomics community has witnessed the growth of large research biobanks, which collect DNA samples for research purposes. Depending on how and where the samples are genotyped, biobanks also offer the potential opportunity to return actionable genomic results to the clinical setting. We developed a preemptive clinical pharmacogenomic implementation initiative via a health system-wide research biobank at the University of Colorado. Here, we describe how preemptive return of clinical pharmacogenomic results via a research biobank is feasible, particularly when coupled with strong institutional support to maximize the impact and efficiency of biobank resources, a multidisciplinary implementation team, automated clinical decision support tools, and proactive strategies to engage stakeholders early in the clinical decision support tool development process.

scholarly journals An Intelligent Clinical Decision Support System for Patient-Specific Predictions to Improve Cervical Intraepithelial Neoplasia Detection

2014 ◽  
Vol 2014 ◽  
pp. 1-20 ◽  
Author(s):  
Panagiotis Bountris ◽  
Maria Haritou ◽  
Abraham Pouliakis ◽  
Niki Margari ◽  
Maria Kyrgiou ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Cervical Intraepithelial Neoplasia ◽  
Clinical Decision Support ◽  
Support System ◽  
Predictive Value ◽  
Clinical Decision Support System ◽  
Intraepithelial Neoplasia ◽  
Clinical Decision ◽  
Patient Specific

Nowadays, there are molecular biology techniques providing information related to cervical cancer and its cause: the human Papillomavirus (HPV), including DNA microarrays identifying HPV subtypes, mRNA techniques such as nucleic acid based amplification or flow cytometry identifying E6/E7 oncogenes, and immunocytochemistry techniques such as overexpression of p16. Each one of these techniques has its own performance, limitations and advantages, thus a combinatorial approach via computational intelligence methods could exploit the benefits of each method and produce more accurate results. In this article we propose a clinical decision support system (CDSS), composed by artificial neural networks, intelligently combining the results of classic and ancillary techniques for diagnostic accuracy improvement. We evaluated this method on 740 cases with complete series of cytological assessment, molecular tests, and colposcopy examination. The CDSS demonstrated high sensitivity (89.4%), high specificity (97.1%), high positive predictive value (89.4%), and high negative predictive value (97.1%), for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+). In comparison to the tests involved in this study and their combinations, the CDSS produced the most balanced results in terms of sensitivity, specificity, PPV, and NPV. The proposed system may reduce the referral rate for colposcopy and guide personalised management and therapeutic interventions.

scholarly journals Clinicians' Values and Preferences for Medication Adherence and Cost Clinical Decision Support in Primary Care: A Qualitative Study

2020 ◽  
Vol 11 (03) ◽  
pp. 405-414
Author(s):  
Shubha Bhat ◽  
Catherine Grace Derington ◽  
Katy E. Trinkley
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Medication Adherence ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Patient Specific ◽  
Specific Information ◽  
Impact Patient Care ◽  
Primary Care Clinicians ◽  
The Cost

Abstract Background Medication nonadherence and unaffordability are prevalent, burdensome issues in primary care. In response, technology companies are capitalizing on clinical decision support (CDS) to deliver patient-specific information regarding medication adherence and costs to clinicians using electronic health records (EHRs). To maximize adoption and usability, these CDS tools should be designed with consideration of end users' values and preferences. Objective This article evaluates primary care clinicians' values and preferences for a medication adherence and cost CDS. Methods We conducted semistructured interviews with primary care clinicians with prescribing privileges and EHR access to identify clinicians' perceptions of and approaches to assessing medication adherence and costs, and to determine perceived values and preferences for medication adherence and cost CDS. Interviews were conducted until saturation of responses was reached. ATLAS.ti was used for thematic analysis. Results Among 26 clinicians interviewed, themes identified included a high value, but moderate need for a medication adherence CDS and high value and need for cost CDS. Clinicians expressed the cost CDS would provide actionable solutions and greatly impact patient care. Another theme identified was a desire for medication adherence and cost CDS to be separate tools yet integrated into workflow. The majority of clinicians preferred a medication adherence CDS that integrated claims data and actively displayed data using color-coded adherence categories within patients' medication lists in the EHR. For the cost CDS, clinicians preferred medication out-of-pocket costs and a list of cheaper or payor-preferred alternatives to display within the order queue of the EHR. Conclusion We identified valuable insights regarding clinician values and preferences for medication adherence and cost CDS. Overall, primary care clinicians feel CDS for medication adherence and cost are valuable and prefer them to be separate. These insights should be used to inform the design, implementation, and EHR integration of future medication and cost CDS tools.

Evaluation of a clinical decision support algorithm for patient-specific childhood immunization

2012 ◽  
Vol 56 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Vivienne J. Zhu ◽  
Shaun J. Grannis ◽  
Wanzhu Tu ◽  
Marc B. Rosenman ◽  
Stephen M. Downs
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Patient Specific ◽  
Childhood Immunization
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