Suppr超能文献

医生对CYP2C19与氯吡格雷药物-基因相互作用的积极临床决策支持警报的看法。

Physician perspectives of CYP2C19 and clopidogrel drug-gene interaction active clinical decision support alerts.

作者信息

Nishimura Adam A, Shirts Brian H, Salama Joseph, Smith Joe W, Devine Beth, Tarczy-Hornoch Peter

机构信息

Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA.

Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.

出版信息

Int J Med Inform. 2016 Feb;86:117-25. doi: 10.1016/j.ijmedinf.2015.11.004. Epub 2015 Nov 11.

Abstract

OBJECTIVE

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.

MATERIALS AND METHODS

52 physicians participated in an online simulation and questionnaire involving a prototype alert for the clopidogrel and CYP2C19 drug-gene interaction.

RESULTS

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.

PRINCIPAL CONCLUSIONS

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.

摘要

目的

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。

材料与方法

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。

结果

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。

主要结论

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。

相似文献

1
Physician perspectives of CYP2C19 and clopidogrel drug-gene interaction active clinical decision support alerts.
Int J Med Inform. 2016 Feb;86:117-25. doi: 10.1016/j.ijmedinf.2015.11.004. Epub 2015 Nov 11.
2
The effect of provider characteristics on the responses to medication-related decision support alerts.
Int J Med Inform. 2015 Sep;84(9):630-9. doi: 10.1016/j.ijmedinf.2015.04.006. Epub 2015 May 9.
6
Physicians' decisions to override computerized drug alerts in primary care.
Arch Intern Med. 2003 Nov 24;163(21):2625-31. doi: 10.1001/archinte.163.21.2625.
7
Drug interaction alert override rates in the Meaningful Use era: no evidence of progress.
Appl Clin Inform. 2014 Sep 3;5(3):802-13. doi: 10.4338/ACI-2013-12-RA-0103. eCollection 2014.
8
Physician response to implementation of genotype-tailored antiplatelet therapy.
Clin Pharmacol Ther. 2016 Jul;100(1):67-74. doi: 10.1002/cpt.331. Epub 2016 Feb 17.
9
Optimization of drug-drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard.
J Am Med Inform Assoc. 2015 Mar;22(2):361-9. doi: 10.1136/amiajnl-2013-002538. Epub 2014 Oct 15.

引用本文的文献

1
Evaluation of CYP2C19 Clinical Decision Support Alerts to Guide P2Y Inhibitor Prescribing.
Clin Pharmacol Ther. 2025 Aug;118(2):470-479. doi: 10.1002/cpt.3698. Epub 2025 May 12.
6
Approaches to assessing the provider experience with clinical pharmacogenomic information: a scoping review.
Genet Med. 2021 Sep;23(9):1589-1603. doi: 10.1038/s41436-021-01186-x. Epub 2021 Apr 29.
7
Integrating pharmacogenetic testing into primary care.
Expert Rev Precis Med Drug Dev. 2017;2(6):327-336. doi: 10.1080/23808993.2017.1398046. Epub 2017 Nov 3.
10
Clinical Informatics Researcher's Desiderata for the Data Content of the Next Generation Electronic Health Record.
Appl Clin Inform. 2017 Oct;8(4):1159-1172. doi: 10.4338/ACI-2017-06-R-0101. Epub 2017 Dec 21.

本文引用的文献

1
Development of clinical decision support alerts for pharmacogenomic incidental findings from exome sequencing.
Genet Med. 2015 Nov;17(11):939-42. doi: 10.1038/gim.2015.5. Epub 2015 Mar 5.
3
Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation.
J Am Med Inform Assoc. 2014 Oct;21(e2):e287-96. doi: 10.1136/amiajnl-2013-002045. Epub 2014 Mar 25.
4
Implementation of pharmacogenetics: the University of Maryland Personalized Anti-platelet Pharmacogenetics Program.
Am J Med Genet C Semin Med Genet. 2014 Mar;166C(1):76-84. doi: 10.1002/ajmg.c.31396. Epub 2014 Mar 10.
7
Platelet function and genetic testing.
J Am Coll Cardiol. 2013 Oct 22;62(17 Suppl):S21-31. doi: 10.1016/j.jacc.2013.08.704.
8
Opportunities for genomic clinical decision support interventions.
Genet Med. 2013 Oct;15(10):817-23. doi: 10.1038/gim.2013.128. Epub 2013 Sep 19.
9
Stakeholder engagement: a key component of integrating genomic information into electronic health records.
Genet Med. 2013 Oct;15(10):792-801. doi: 10.1038/gim.2013.127. Epub 2013 Sep 12.
10
Development and use of active clinical decision support for preemptive pharmacogenomics.
J Am Med Inform Assoc. 2014 Feb;21(e1):e93-9. doi: 10.1136/amiajnl-2013-001993. Epub 2013 Aug 26.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验