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理解电子药品库的参与度及其潜在影响:多方法研究。

Understanding Engagement and the Potential Impact of an Electronic Drug Repository: Multi-Methods Study.

作者信息

Soobiah Charlene, Phung Michelle, Tadrous Mina, Jamieson Trevor, Bhatia R Sacha, Desveaux Laura

机构信息

Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada.

出版信息

JMIR Form Res. 2022 Mar 30;6(3):e27158. doi: 10.2196/27158.

Abstract

BACKGROUND

Centralized drug repositories can reduce adverse events and inappropriate prescriptions by enabling access to dispensed medication data at the point of care; however, how they achieve this goal is largely unknown.

OBJECTIVE

This study aims to understand the perceived clinical value; the barriers to and enablers of adoption; and the clinician groups for which a provincial, centralized drug repository may provide the most benefit.

METHODS

A mixed methods approach, including a web-based survey and semistructured interviews, was used. Participants were clinicians (eg, nurses, physicians, and pharmacists) in Ontario who were eligible to use the digital health drug repository (DHDR), irrespective of actual use. Survey data were ranked on a 7-point adjectival scale and analyzed using descriptive statistics, and interviews were analyzed using qualitative descriptions.

RESULTS

Of the 161 survey respondents, only 40 (24.8%) actively used the DHDR. Perceptions of the utility of the DHDR were neutral (mean scores ranged from 4.11 to 4.76). Of the 75.2% (121/161) who did not use the DHDR, 97.5% (118/121) rated access to medication information (eg, dose, strength, and frequency) as important. Reasons for not using the DHDR included the cumbersome access process and the perception that available data were incomplete or inaccurate. Of the 33 interviews completed, 26 (79%) were active DHDR users. The DHDR was a satisfactory source of secondary information; however, the absence of medication instructions and prescribed medications (which were not dispensed) limited its ability to provide a comprehensive profile to meaningfully support clinical decision-making.

CONCLUSIONS

Digital drug repositories must be adjusted to align with the clinician's needs to provide value. Ensuring integration with point-of-care systems, comprehensive clinical data, and streamlined onboarding processes would optimize clinically meaningful use. The electronic provision of accessible drug information to providers across health care settings has the potential to improve efficiency and reduce medication errors.

摘要

背景

集中式药品库可通过在医疗点提供已配发药品数据来减少不良事件和不适当处方;然而,其实现这一目标的方式在很大程度上尚不清楚。

目的

本研究旨在了解感知到的临床价值;采用的障碍和促进因素;以及省级集中式药品库可能最有益的临床医生群体。

方法

采用混合方法,包括基于网络的调查和半结构化访谈。参与者是安大略省有资格使用数字健康药品库(DHDR)的临床医生(如护士、医生和药剂师),无论其实际使用情况如何。调查数据按7分形容词量表进行排名,并使用描述性统计进行分析,访谈则使用定性描述进行分析。

结果

在161名调查受访者中,只有40人(24.8%)积极使用DHDR。对DHDR效用的看法为中性(平均得分在4.11至4.76之间)。在未使用DHDR的75.2%(121/161)受访者中,97.5%(118/121)认为获取用药信息(如剂量、强度和频率)很重要。不使用DHDR的原因包括获取过程繁琐以及认为可用数据不完整或不准确。在完成的33次访谈中,26人(79%)是DHDR的活跃用户。DHDR是二级信息的令人满意的来源;然而,缺少用药说明和未配发的处方药限制了其提供全面信息以切实支持临床决策的能力。

结论

数字药品库必须进行调整以符合临床医生的需求以提供价值。确保与医疗点系统、全面临床数据和简化的入职流程集成将优化具有临床意义的使用。向各医疗环境中的提供者电子提供可获取的药品信息有可能提高效率并减少用药错误。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c2d/9008523/b42d48b2c93e/formative_v6i3e27158_fig1.jpg

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