Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Pittsburgh Healthcare System (VAPHS), Pittsburgh, PA; Center for Health Equity Research and Promotion (CHERP), VAPHS, Pittsburgh, PA; Geriatric Pharmaceutical Outcomes and Geroinformatics Research and Training Program, University of Pittsburgh, Pittsburgh, PA.
J Am Med Dir Assoc. 2013 Dec;14(12):906-10. doi: 10.1016/j.jamda.2013.08.014. Epub 2013 Oct 2.
Although mobile devices equipped with drug reference software may help prevent adverse drug events (ADEs) in the nursing home (NH) by providing medication information at the point of care, little is known about their use and perceived benefits. The goal of this study was to conduct a survey of a nationally representative sample of NH physicians to quantify the use and perceived benefits of mobile devices in preventing ADEs in the NH setting.
DESIGN/SETTING/PARTICIPANTS: We surveyed physicians who attended the 2010 American Medical Directors Association Annual Symposium about their use of mobile devices, and beliefs about the effectiveness of drug reference software in preventing ADEs.
The overall net valid response rate was 70% (558/800) with 42% (236/558) using mobile devices to assist with prescribing in the NH. Physicians with 15 or fewer years of clinical experience were 67% more likely to be mobile device users, compared with those with more than 15 years of clinical experience (odds ratio = 1.68; 95% confidence interval = 1.17-2.41; P = .005). For those who used a mobile device to assist with prescribing, almost all (98%) reported performing an average of 1 or more drug look-ups per day, performed an average of 1 to 2 lookups per day for potential drug-drug interactions (DDIs), and most (88%) believed that drug reference software had helped to prevent at least 1 potential ADE in the preceding 4-week period.
The proportion of NH physicians who use mobile devices with drug reference software, although significant, is lower than in other clinical environments. Our results suggest that NH physicians who use mobile devices equipped with drug reference software believe they are helpful for reducing ADEs. Further research is needed to better characterize the facilitators and barriers to adoption of the technology in the NH and its precise impact on NH ADEs.
尽管配备药物参考软件的移动设备可以通过在护理点提供药物信息来帮助预防疗养院（NH）中的不良药物事件（ADE），但对于它们的使用和感知益处却知之甚少。本研究的目的是对全国范围内具有代表性的 NH 医生样本进行调查，以量化移动设备在 NH 环境中预防 ADE 的使用情况和感知益处。
设计/设置/参与者：我们调查了参加 2010 年美国医疗主任协会年会的医生，了解他们使用移动设备的情况以及他们对药物参考软件在预防 ADE 方面的有效性的看法。
总的网络有效回复率为 70%（558/800），其中 42%（236/558）的医生在 NH 使用移动设备协助开处方。与具有 15 年以上临床经验的医生相比，具有 15 年或更短临床经验的医生更有可能成为移动设备使用者（优势比=1.68；95%置信区间=1.17-2.41；P=0.005）。对于那些使用移动设备协助开处方的人，几乎所有人（98%）报告每天平均进行 1 次或更多次药物查询，每天平均进行 1 到 2 次药物相互作用（DDI）查询，并且大多数（88%）认为药物参考软件在过去 4 周内至少帮助预防了 1 次潜在的 ADE。
尽管使用配备药物参考软件的移动设备的 NH 医生比例很高，但仍低于其他临床环境。我们的结果表明，使用配备药物参考软件的移动设备的 NH 医生认为它们有助于减少 ADE。需要进一步研究以更好地描述 NH 中采用该技术的促进因素和障碍以及它对 NH ADE 的精确影响。
