Louvain Drug Research Institute, Clinical Pharmacy Research Group, Université catholique de Louvain, Brussels, Belgium.
Geriatric Medicine, Cliniques universitaires Saint-Luc, Brussels, Belgium.
J Am Med Inform Assoc. 2018 Nov 1;25(11):1488-1500. doi: 10.1093/jamia/ocy107.
Medication reconciliation (MedRec) can improve patient safety by resolving medication discrepancies. Because information technology (IT) and patient engagement are promising approaches to optimizing MedRec, the SEAMPAT project aims to develop a MedRec IT platform based on two applications: the "patient app" and the "MedRec app." This study evaluates three dimensions of the usability (efficiency, satisfaction, and effectiveness) and usefulness of the patient app.
We performed a four-month user-centered observational study. Quantitative and qualitative data were collected. Participants completed the system usability scale (SUS) questionnaire and a second questionnaire on usefulness. Effectiveness was assessed by measuring the completeness of the medication list generated by the patient application and its correctness (ie medication discrepancies between the patient list and the best possible medication history). Qualitative data were collected from semi-structured interviews, observations and comments, and questions raised by patients.
Forty-two patients completed the study. Sixty-nine percent of patients considered the patient app to be acceptable (SUS Score ≥ 70) and usefulness was high. The medication list was complete for a quarter of the patients (7/28) and there was a discrepancy for 21.7% of medications (21/97). The qualitative data enabled the identification of several barriers (related to functional and non-functional aspects) to the optimization of usability and usefulness.
Our findings highlight the importance and value of user-centered usability testing of a patient application implemented in "real-world" conditions. To achieve adoption and sustained use by patients, the app should meet patients' needs while also efficiently improving the quality of MedRec.
药物重整（MedRec）可以通过解决药物差异来提高患者安全性。由于信息技术（IT）和患者参与是优化 MedRec 的有前途的方法，因此 SEAMPAT 项目旨在开发一个基于两个应用程序的 MedRec IT 平台：“患者应用程序”和“MedRec 应用程序”。本研究评估了患者应用程序的三个可用性（效率、满意度和有效性）和有用性维度。
我们进行了为期四个月的以用户为中心的观察性研究。收集了定量和定性数据。参与者完成了系统可用性量表（SUS）问卷和第二个关于有用性的问卷。通过测量患者应用程序生成的药物清单的完整性及其正确性（即患者清单与最佳可能药物史之间的药物差异）来评估有效性。从半结构化访谈、观察和评论以及患者提出的问题中收集了定性数据。
42 名患者完成了研究。69%的患者认为患者应用程序是可以接受的（SUS 得分≥70），并且有用性很高。有四分之一的患者（28 人中的 7 人）的药物清单完整，有 21.7%的药物存在差异（97 种药物中的 21 种）。定性数据使我们能够确定几个可用性和有用性优化的障碍（与功能和非功能方面有关）。
我们的研究结果强调了在“真实世界”条件下对患者应用程序进行以用户为中心的可用性测试的重要性和价值。为了实现患者的采用和持续使用，应用程序应满足患者的需求，同时有效提高 MedRec 的质量。
