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A simulation trial evaluating ABiMed, a clinical decision support system for medication reviews and polypharmacy management.

作者信息

Mouazer Abdelmalek, Dubois Sophie, Léguillon Romain, Boudegzdame Nada, Levrard Thibaud, Le Bars Yoann, Simon Christian, Séroussi Brigitte, Grosjean Julien, Lelong Romain, Letord Catherine, Darmoni Stéfan, Sedki Karima, Meneton Pierre, Tsopra Rosy, Falcoff Hector, Lamy Jean-Baptiste

机构信息

INSERM, Sorbonne Université, Université Sorbonne Paris-Nord, Limics, 75006, Paris, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France.

SFTG Recherche (Société de Formation Thérapeutique du Généraliste), Paris, France.

出版信息

Res Social Adm Pharm. 2025 Nov;21(11):904-913. doi: 10.1016/j.sapharm.2025.06.006. Epub 2025 Jun 19.

DOI:10.1016/j.sapharm.2025.06.006
PMID:40555596
Abstract

BACKGROUND

Medication review is a structured interview of the patient, performed by the pharmacist and aimed at optimizing drug treatments. In practice, medication review is a long and cognitively-demanding task that requires specific knowledge. Various tools and criteria have been proposed, but their application is tedious.

METHODS

We designed ABiMed, a clinical decision support system for medication reviews. The design was supported by literature reviews and clinicians focus groups. ABiMed supports the pharmacist by implementing the STOPP/START v2 criteria and by presenting aggregated drug knowledge, such as dosage, interactions or adverse effects, visually using tables, graphs and flower glyphs. We evaluated ABiMed with 39 community pharmacists during a simulation trial, each pharmacist performing a medication review for two fictitious patients without ABiMed, and two others with ABiMed. We recorded the problems identified by the pharmacist, the interventions proposed, the response time, the perceived usability and the comments. Pharmacists' medication reviews were compared to an expert-designed gold standard.

RESULTS

With ABiMed, pharmacists found 1.6 times more relevant drug-related problems during the medication review (p < 0.0001) and proposed better interventions (p < 0.0001), without needing more time (p = 0.56). The System Usability Scale score is 82.7, which is ranked "excellent". In their comments, pharmacists appreciated the visual aspect of ABiMed and its ability to compare the current treatment with the proposed one. A multifactor analysis showed no difference in the support offered by ABiMed according to the pharmacist's age or sex, in terms of percentage of problems identified or quality of the proposed interventions.

CONCLUSIONS

The use of an intelligent and visual clinical decision support system can help pharmacists when they perform medication reviews. Our main perspective is the evaluation of the system with real patients, and its diffusion among pharmacists.

摘要

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