Improving the usability and usefulness of computerized decision support systems for medication review by clinical pharmacists: A convergent, parallel evaluation.

Clinical pharmacists Decision support systems Ergonomics Medication review

Journal

Research in social & administrative pharmacy : RSAP
ISSN: 1934-8150
Titre abrégé: Res Social Adm Pharm
Pays: United States
ID NLM: 101231974

Informations de publication

Date de publication:
01 2023
Historique:
received: 28 01 2022
revised: 09 06 2022
accepted: 13 08 2022
pubmed: 11 9 2022
medline: 1 12 2022
entrez: 10 9 2022
Statut: ppublish

Résumé

Computerized decision support systems (CDSSs) help hospital-based clinical pharmacists to perform medication reviews and so are promising tools for improving medication safety. However, their poor usability can reduce effectiveness and acceptability. To evaluate the usability and perceived usefulness of a CDSS for medication review by hospital-based pharmacists and to draw up guidelines on improving its usability. We performed a convergent, parallel evaluation. Firstly, three researchers conducted a heuristic evaluation of the CDSS. Secondly, clinical pharmacists who use the CDSS filled out the Usefulness, Satisfaction and Ease of Use (USE) questionnaire. Lastly, semi-structured interviews with the pharmacists enabled us to understand their opinions and experiences. The results of the heuristic evaluation were used to identify potential improvements in the CDSS. We performed a statistical analysis of the USE questionnaire data. Interviews were analyzed based on the unified theory of acceptance and use of technology (UTAUT), together with a task-technology fit model. The results generated by these three approaches were compared in order to determine convergences and divergences, identify challenges related to the usability and usefulness of the CDSS, and draw up guidelines for its improvement. Forty-seven usability problems were discovered; they variously concerned the graphical user interface, the pharmacists' needs, and the medication review model implemented in the CDSS. Only the "usefulness" dimension of the USE was not scored positively. All the UTAUT dimensions and the task-technology fit dimension emerged in the interviews. Cross-comparisons of the results from the three approaches led to the identification of four challenges and the corresponding formulation of 23 guidelines. The guidelines developed here should help to improve the design and acceptability of CDSSs. Hence, CDSSs will be able to assist clinical pharmacists more fully with their medication reviews and help to further improve patient safety.

Sections du résumé

BACKGROUND
Computerized decision support systems (CDSSs) help hospital-based clinical pharmacists to perform medication reviews and so are promising tools for improving medication safety. However, their poor usability can reduce effectiveness and acceptability.
OBJECTIVES
To evaluate the usability and perceived usefulness of a CDSS for medication review by hospital-based pharmacists and to draw up guidelines on improving its usability.
METHODS
We performed a convergent, parallel evaluation. Firstly, three researchers conducted a heuristic evaluation of the CDSS. Secondly, clinical pharmacists who use the CDSS filled out the Usefulness, Satisfaction and Ease of Use (USE) questionnaire. Lastly, semi-structured interviews with the pharmacists enabled us to understand their opinions and experiences. The results of the heuristic evaluation were used to identify potential improvements in the CDSS. We performed a statistical analysis of the USE questionnaire data. Interviews were analyzed based on the unified theory of acceptance and use of technology (UTAUT), together with a task-technology fit model. The results generated by these three approaches were compared in order to determine convergences and divergences, identify challenges related to the usability and usefulness of the CDSS, and draw up guidelines for its improvement.
RESULTS
Forty-seven usability problems were discovered; they variously concerned the graphical user interface, the pharmacists' needs, and the medication review model implemented in the CDSS. Only the "usefulness" dimension of the USE was not scored positively. All the UTAUT dimensions and the task-technology fit dimension emerged in the interviews. Cross-comparisons of the results from the three approaches led to the identification of four challenges and the corresponding formulation of 23 guidelines.
CONCLUSIONS
The guidelines developed here should help to improve the design and acceptability of CDSSs. Hence, CDSSs will be able to assist clinical pharmacists more fully with their medication reviews and help to further improve patient safety.

Identifiants

pubmed: 36088188
pii: S1551-7411(22)00278-9
doi: 10.1016/j.sapharm.2022.08.012
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

144-154

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships with KeenTurtle (the publisher of the PharmaClass® CDSS) that could have appeared to influence the work reported in this paper.

Auteurs

Romaric Marcilly (R)

Univ. Lille, CHU Lille, ULR 2694 - METRICS, Health Technology Assessment and Medical Practices, F-59000, Lille, France; Inserm, CIC-IT 1403, F-59000, Lille, France. Electronic address: romaric.marcilly@univ-lille.fr.

Jeremie Colliaux (J)

Inserm, CIC-IT 1403, F-59000, Lille, France. Electronic address: jeremie.colliaux@univ-lille.fr.

Laurine Robert (L)

CHU Lille, Institute of Pharmacy, F-59000, Lille, France. Electronic address: laurine.robert@chru-lille.fr.

Sylvia Pelayo (S)

Univ. Lille, CHU Lille, ULR 2694 - METRICS, Health Technology Assessment and Medical Practices, F-59000, Lille, France; Inserm, CIC-IT 1403, F-59000, Lille, France. Electronic address: sylvia.pelayo@univ-lille.fr.

Jean-Baptiste Beuscart (JB)

Univ. Lille, CHU Lille, ULR 2694 - METRICS, Health Technology Assessment and Medical Practices, F-59000, Lille, France; CHU Lille, Geriatric Service, F-59000, Lille, France. Electronic address: jean-baptiste.beuscart@univ-lille.fr.

Chloé Rousselière (C)

CHU Lille, Institute of Pharmacy, F-59000, Lille, France. Electronic address: chloe.rousseliere@chru-lille.fr.

Bertrand Décaudin (B)

CHU Lille, Institute of Pharmacy, F-59000, Lille, France; Univ. Lille, CHU Lille, ULR 7365 - GRITA - Research Group on Injectable Forms and Associated Technologies, F-59000 Lille, France. Electronic address: bertrand.decaudin@chru-lille.fr.

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