Development and pilot testing of PHARAO-a decision support system for pharmacological risk assessment in the elderly
Autor: | Marine L. Andersson, Tero Shemeikka, Maria Edlert, Janne Lähdesmäki, Margaretha Julander, Tuomas Korhonen, Ylva Böttiger, Kari Laine |
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Rok vydání: | 2017 |
Předmět: |
Risk
medicine.medical_specialty Decision support system Drug-Related Side Effects and Adverse Reactions Attitude of Health Personnel Pharmacoepidemiology and Prescription Pharmacology toxicology Social and Clinical Pharmacy Adverse drug reaction Clinical decision support system Drug interactions Polypharmacy Elderly Pilot Projects Comorbidity 030226 pharmacology & pharmacy Risk profile Risk Assessment 03 medical and health sciences 0302 clinical medicine Drug Utilization Review Medicine Humans Pharmacology (medical) 030212 general & internal medicine Intensive care medicine Adverse effect Geriatric Assessment Finland Aged Pharmacology Aged 80 and over Sweden Internet Primary Health Care business.industry Samhällsfarmaci och klinisk farmaci General Medicine medicine.disease Decision Support Systems Clinical Geriatrics Chronic Disease Workforce business Risk assessment |
Zdroj: | European Journal of Clinical Pharmacology |
ISSN: | 1432-1041 |
Popis: | Purpose The aims of this study are to describe the development of PHARAO (Pharmacological Risk Assessment Online), a decision support system providing a risk profile for adverse events, associated with combined effects of multiple medicines, and to present data from a pilot study, testing the use, functionality, and acceptance of the PHARAO system in a clinical setting. Methods About 1400 substances were scored in relation to their risk to cause any of nine common and/or serious adverse effects. Algorithms for each adverse effect score were developed to create individual risk profiles from the patient’s list of medication. The system was tested and integrated to the electronic medical record, during a 4-month period in two geriatric wards and three primary healthcare centers, and a questionnaire was answered by the users before and after the test period. Results A total of 732 substances were tagged with one or more of the nine risks, most commonly with the risk of sedation or seizures. During the pilot, the system was used 933 times in 871 patients. The most common signals generated by PHARAO in these patients were related to the risks of constipation, sedation, and bleeding. A majority of responders considered PHARAO easy to use and that it gives useful support in performing medication reviews. Conclusions The PHARAO decision support system, designed as a complement to a database on drug-drug interactions used nationally, worked as intended and was appreciated by the users during a 4-month test period. Integration aspects need to be improved to minimize unnecessary signaling. |
Databáze: | OpenAIRE |
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