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了解使用CancelRx的药房工作人员的信息需求:一项关于处方取消使用情况的定性研究。

Understanding the Information Needs of Pharmacy Staff Using CancelRx: A Qualitative Study of the Use of Prescription -cancellation.

作者信息

Hurley Vanessa B, Giletta Elaine, Yang Yushi, Mollenkopf Nicole L, Jalalzai Rabia, Schwartz Jessica L, Chen Allen R, Pitts Samantha I

机构信息

Health Management and Policy, School of Health, Georgetown University, St. Mary's Hall 231, 3700 Reservoir Rd NW, Washington, DC 20057, United States.

Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States.

出版信息

Explor Res Clin Soc Pharm. 2023 Dec 14;13:100398. doi: 10.1016/j.rcsop.2023.100398. eCollection 2024 Mar.

Abstract

BACKGROUND

Although electronic prescription cancellation such as via CancelRx can facilitate critical communication between prescribers and pharmacy staff about discontinued medications, there is little work that explores whether CancelRx meets the needs of pharmacy staff users.

OBJECTIVE

This study leverages qualitative interviews with pharmacy staff to address the following question:

METHODS

We conducted an inductive thematic analysis of interviews with 11 pharmacy staff members (pharmacists and pharmacy technicians) across three outpatient community pharmacy sites within an academic health care system.

RESULTS

Three information needs themes were consistently identified by both pharmacists and pharmacy technicians: prescriber intent when initiating the CancelRx, clinical rationale for the medication change, and intended medication regimen. Notably, both pharmacists and pharmacy technicians often reported seeking multiple information needs not fully addressed by CancelRx in the electronic health record (EHR) to achieve the shared goals of correct dispensing of medications and supporting patient self-management.

CONCLUSIONS

Our qualitative analysis reveals that outpatient community pharmacy staff in an academic health care system often seek additional information from the (EHR) following medication changes communicated by CancelRx to meet their information needs. Ideally, the prescriber would provide sufficient information through CancelRx to automatically identify all discontinued prescriptions. These limitations highlight the need for design features that support routine communication of needed information at the time of a medication change, such as structured data elements.

摘要

背景

尽管诸如通过CancelRx进行电子处方取消可以促进开处方者与药房工作人员之间就停用药物进行关键沟通,但很少有研究探讨CancelRx是否满足药房工作人员用户的需求。

目的

本研究通过对药房工作人员进行定性访谈来解决以下问题:

方法

我们对学术医疗保健系统内三个门诊社区药房站点的11名药房工作人员(药剂师和药房技术员)进行的访谈进行了归纳主题分析。

结果

药剂师和药房技术员一致确定了三个信息需求主题:发起CancelRx时开处方者的意图、药物变更的临床理由以及预期的药物治疗方案。值得注意的是,药剂师和药房技术员都经常报告说,他们在电子健康记录(EHR)中寻求CancelRx未完全满足的多种信息需求,以实现正确配药和支持患者自我管理的共同目标。

结论

我们的定性分析表明,学术医疗保健系统中的门诊社区药房工作人员在通过CancelRx传达药物变更后,经常会从电子健康记录(EHR)中寻求更多信息以满足他们的信息需求。理想情况下,开处方者应通过CancelRx提供足够的信息,以自动识别所有停用的处方。这些限制凸显了在药物变更时支持常规传达所需信息的设计功能的必要性,例如结构化数据元素。

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本文引用的文献

1
The Impact of Electronic Communication of Medication Discontinuation (CancelRx) on Medication Safety: A Pilot Study.
J Patient Saf. 2022 Sep 1;18(6):e934-e937. doi: 10.1097/PTS.0000000000000998. Epub 2022 Apr 5.
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Pharmacists without Access to the EHR: Practicing with One Hand Tied Behind Our Backs.
Innov Pharm. 2021 Jun 10;12(3). doi: 10.24926/iip.v12i3.4141. eCollection 2021.
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CancelRx implementation: Observed changes to medication discontinuation workflows over time.
Explor Res Clin Soc Pharm. 2022 Jan 25;5:100108. doi: 10.1016/j.rcsop.2022.100108. eCollection 2022 Mar.
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CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.
J Am Med Inform Assoc. 2021 Jul 14;28(7):1526-1533. doi: 10.1093/jamia/ocab038.
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Understanding CancelRx: Results of End-to-End Functional Testing, Proactive Risk Assessment, and Pilot Implementation.
Appl Clin Inform. 2019 Mar;10(2):336-347. doi: 10.1055/s-0039-1688698. Epub 2019 May 22.
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