Barriers to Adoption of Tailored Drug-Drug Interaction Clinical Decision Support.


Journal

Applied clinical informatics
ISSN: 1869-0327
Titre abrégé: Appl Clin Inform
Pays: Germany
ID NLM: 101537732

Informations de publication

Date de publication:
08 2023
Historique:
pmc-release: 04 10 2024
medline: 1 11 2023
pubmed: 5 10 2023
entrez: 4 10 2023
Statut: ppublish

Résumé

Despite the benefits of the tailored drug-drug interaction (DDI) alerts and the broad dissemination strategy, the uptake of our tailored DDI alert algorithms that are enhanced with patient-specific and context-specific factors has been limited. The goal of the study was to examine barriers and health care system dynamics related to implementing tailored DDI alerts and identify the factors that would drive optimization and improvement of DDI alerts. We employed a qualitative research approach, conducting interviews with a participant interview guide framed based on Proctor's taxonomy of implementation outcomes and informed by the Theoretical Domains Framework. Participants included pharmacists with informatics roles within hospitals, chief medical informatics officers, and associate medical informatics directors/officers. Our data analysis was informed by the technique used in grounded theory analysis, and the reporting of open coding results was based on a modified version of the Safety-Related Electronic Health Record Research Reporting Framework. Our analysis generated 15 barriers, and we mapped the interconnections of these barriers, which clustered around three entities (i.e., users, organizations, and technical stakeholders). Our findings revealed that misaligned interests regarding DDI alert performance and misaligned expectations regarding DDI alert optimizations among these entities within health care organizations could result in system inertia in implementing tailored DDI alerts. Health care organizations primarily determine the implementation and optimization of DDI alerts, and it is essential to identify and demonstrate value metrics that health care organizations prioritize to enable tailored DDI alert implementation. This could be achieved via a multifaceted approach, such as partnering with health care organizations that have the capacity to adopt tailored DDI alerts and identifying specialists who know users' needs, liaise with organizations and vendors, and facilitate technical stakeholders' work. In the future, researchers can adopt the systematic approach to study tailored DDI implementation problems from other system perspectives (e.g., the vendors' system).

Identifiants

pubmed: 37793617
doi: 10.1055/s-0043-1772686
pmc: PMC10550365
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

779-788

Subventions

Organisme : AHRQ HHS
ID : R01 HS025984
Pays : United States

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

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Auteurs

Tianyi Zhang (T)

Department of Systems and Industrial Engineering, College of Engineering, University of Arizona, Tucson, Arizona.

Sheila M Gephart (SM)

Advanced Nursing Practice and Science Division, College of Nursing, University of Arizona, Tucson, Arizona.

Vignesh Subbian (V)

Department of Systems and Industrial Engineering, College of Engineering, University of Arizona, Tucson, Arizona.

Richard D Boyce (RD)

Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

Lorenzo Villa-Zapata (L)

Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, Georgia.

Malinda S Tan (MS)

Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah.

John Horn (J)

Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, Washington.

Ainhoa Gomez-Lumbreras (A)

Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah.

Andrew V Romero (AV)

Department of Pharmacy, Tucson Medical Center, Tucson, Arizona.

Daniel C Malone (DC)

Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah.

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