Oudbier S J, Aarts J W, Kloes van der J M, Kuijvenhoven M A, Janssen S L, Hilhorst M, Nurmohamed S A, Smets E M A, Teeuwisse P J I, Dusseljee-Peute L W
Amsterdam UMC Location University of Amsterdam, Outpatient Division, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Digital Health, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
Amsterdam UMC, Department of Clinical Pharmacology and Pharmacy, Amsterdam, the Netherlands.
Int J Med Inform. 2025 Sep;201:105949. doi: 10.1016/j.ijmedinf.2025.105949. Epub 2025 Apr 23.
With an aging population and the increasing prevalence of chronic diseases such as chronic kidney disease (CKD), kidney transplantation is the preferred treatment for end-stage renal disease due to its superior clinical outcomes and cost-effectiveness compared to dialysis. Although EHR-integrated medication reminders have the potential to enhance adherence in transplant patients, their feasibility require further investigation.
The objective of this pilot study was to assess the feasibility of an integrated medication reminder tool for kidney transplant patients in terms of experienced usability and satisfaction.
A single-arm survey design was used to assess the usability and satisfaction in kidney transplant recipients using an EHR-integrated medication reminder tool through the patient portal at a large academic hospital in the Netherlands. Usability and satisfaction were evaluated using the validated Experienced Usability and Satisfaction with self-monitoring in the home Setting (GEMS) questionnaire comprising four subconstructs: Convenience of use, Perceived value, Efficiency of use, and Satisfaction. Quantitative data were analysed and assessed through descriptive statistics. Furthermore, six additional questions assessed logging into the system, ease of follow-up on reminder, satisfaction with reminder timing, perceived support for adherence, occurrence of incorrect reminders, and willingness to continue using the tool, using Likert scales and open-ended responses.
In total, forty-three patients participated in this study. The results showed mixed experienced usability and satisfaction, with a GEMS score of 65.0%. The Efficiency of use subconstruct revealed issues such as difficulties in checking off medication and accessing the patient portal. The Satisfaction subconstruct revealed limitations of the tool, as reminders cannot be customized, creating inconvenience for patients who had developed their own medication routines after transplantation. One third (35.7%) of the patients reported willingness to continue using the tool after the pilot program.
The experienced usability and satisfaction of an integrated EHR medication reminder tool were adequate for half of the patients. To facilitate large-scale implementation, improvements of the tool are needed to maximize its effectiveness for kidney transplant patients, particularly by enhancing customization of the notification system to better meet user needs and support medication adherence.
随着人口老龄化以及慢性肾脏病（CKD）等慢性病患病率的上升，与透析相比，肾移植因其卓越的临床疗效和成本效益，成为终末期肾病的首选治疗方法。尽管电子健康记录（EHR）集成的用药提醒有提高移植患者依从性的潜力，但其可行性仍需进一步研究。
本试点研究的目的是从体验到的可用性和满意度方面评估一种针对肾移植患者的集成用药提醒工具的可行性。
采用单臂调查设计，通过荷兰一家大型学术医院的患者门户，使用EHR集成的用药提醒工具来评估肾移植受者的可用性和满意度。使用经过验证的《家庭环境中自我监测的体验可用性和满意度》（GEMS）问卷评估可用性和满意度，该问卷包括四个子结构：使用便利性、感知价值、使用效率和满意度。通过描述性统计分析和评估定量数据。此外，还通过李克特量表和开放式回答，增加了六个问题，以评估登录系统、提醒跟进的 ease、对提醒时间的满意度、对依从性的感知支持、错误提醒的发生情况以及继续使用该工具的意愿。
共有43名患者参与了本研究。结果显示，体验到的可用性和满意度参差不齐，GEMS评分为65.0%。使用效率子结构揭示了诸如勾选用药和访问患者门户困难等问题。满意度子结构揭示了该工具的局限性，因为提醒无法定制，这给移植后已形成自己用药习惯的患者带来不便。三分之一（35.7%）的患者表示在试点项目后愿意继续使用该工具。
集成的EHR用药提醒工具对一半的患者来说，体验到的可用性和满意度是足够的。为便于大规模实施，需要对该工具进行改进，以最大限度地提高其对肾移植患者的有效性，特别是通过增强通知系统的定制性，以更好地满足用户需求并支持用药依从性。
