Westerbeek L, Linn A J, van Weert H C, van der Velde N, Medlock S, Abu-Hanna A, van Weert J C M
Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
NPJ Digit Med. 2025 Jul 11;8(1):431. doi: 10.1038/s41746-025-01822-9.
Falls are a major cause of injuries among older people, with medication being a key risk factor. The SNOWDROP intervention introduces a clinical decision support system for general practitioners (GPs) offering personalized deprescribing advice, and a patient portal containing information and a question prompt list. This study evaluates the intervention's effectiveness through a cluster randomized controlled trial in six general practices, with 84 patients (M = 78.01, SD = 5.71). Patients discussed their medication-related fall risk with their GP. Data were collected via questionnaires and audio-recorded consultations. The intervention increased shared decision-making for both GPs (p < 0.001) and patients (p < 0.001), increased patients' satisfaction with communication (p = 0.001), and reduced patients' decisional conflict (p < 0.001). Patients' beliefs about medication (necessity and concerns) remained stable. The effect on changes to the medication was inconclusive. These results highlight the potential of technology in healthcare and warrant future research.
跌倒是老年人受伤的主要原因，药物是一个关键风险因素。雪滴花干预措施为全科医生引入了一个临床决策支持系统，提供个性化的减药建议，以及一个包含信息和问题提示列表的患者门户网站。本研究通过在六个全科诊所进行的整群随机对照试验，对84名患者（M = 78.01，标准差 = 5.71）评估了该干预措施的有效性。患者与他们的全科医生讨论了与药物相关的跌倒风险。通过问卷调查和录音咨询收集数据。该干预措施增加了全科医生（p < 0.001）和患者（p < 0.001）的共同决策，提高了患者对沟通的满意度（p = 0.001），并减少了患者的决策冲突（p < 0.001）。患者对药物的信念（必要性和担忧）保持稳定。对药物变化的影响尚无定论。这些结果凸显了技术在医疗保健中的潜力，值得未来开展研究。
