Nishimura Adam A, Shirts Brian H, Salama Joseph, Smith Joe W, Devine Beth, Tarczy-Hornoch Peter
Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA.
Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
Int J Med Inform. 2016 Feb;86:117-25. doi: 10.1016/j.ijmedinf.2015.11.004. Epub 2015 Nov 11.
To determine if physicians find clinical decision support alerts for pharmacogenomic drug-gene interactions useful and assess their perceptions of usability aspects that impact usefulness.
52 physicians participated in an online simulation and questionnaire involving a prototype alert for the clopidogrel and CYP2C19 drug-gene interaction.
Only 4% of participants stated they would override the alert. 92% agreed that the alerts were useful. 87% found the visual interface appropriate, 91% felt the timing of the alert was appropriate and 75% were unfamiliar with the specific drug-gene interaction. 80% of providers preferred the ability to order the recommended medication within the alert. Qualitative responses suggested that supplementary information is important, but should be provided as external links, and that the utility of pharmacogenomic alerts depends on the broader ecosystem of alerts.
Pharmacogenomic alerts would be welcomed by many physicians, can be built with minimalist design principles, and are appropriately placed at the end of the prescribing process. Since many physicians lack familiarity with pharmacogenomics but have limited time, information and educational resources within the alert should be carefully selected and presented in concise ways.
确定医生是否认为药物基因组学药物-基因相互作用的临床决策支持警报有用,并评估他们对影响其有用性的可用性方面的看法。
52名医生参与了一项在线模拟和问卷调查,内容涉及氯吡格雷与CYP2C19药物-基因相互作用的原型警报。
只有4%的参与者表示他们会忽略该警报。92%的人认为警报有用。87%的人认为视觉界面合适,91%的人觉得警报的时机合适,75%的人不熟悉特定的药物-基因相互作用。80%的医疗服务提供者更喜欢在警报中能够订购推荐药物的功能。定性反馈表明,补充信息很重要,但应以外部链接的形式提供,并且药物基因组学警报的效用取决于更广泛的警报生态系统。
药物基因组学警报会受到许多医生的欢迎,可以采用简约设计原则构建,并恰当地置于处方流程末尾。由于许多医生对药物基因组学缺乏了解,但时间、信息和教育资源有限,警报中的信息应仔细挑选并以简洁的方式呈现。