ప్రాథమిక సంరక్షణలో నాణ్యత అందరికి ప్రవేశం

నైరూప్య

‘Something that Facilitates Our Work…rather than a Hindrance’: Clinical Pharmacist Perspectives on the Use of Data Analytics to Support Polypharmacy Medication reviews in Primary Care

Ruth Hurley*, Francine Jury, Tjeerd P. Van Staa, Victoria Palin, Christopher J. Armitage

Background: Polypharmacy and overprescribing pose an enormous challenge to safe healthcare and efficient use of resources. Patient record data could inform safer prescribing and deprescribing, but it is unclear how these complex data should be summarized and displayed to clinicians. The current study examined the perspectives of clinical pharmacists (CPs), a newly expanding workforce of primary care medication specialists, to explore ways that novel analytics could help improve health outcomes for frail and elderly (>65 yrs) patients.

Methods: The utility of novel analytics interventions were discussed in an exploratory scoping workshop. Health risk data for frail and elderly patients with polypharmacy (modelled from extensive national datasets) were presented to primary care clinical pharmacists (n=14). Verbal and textual comments were thematically analyzed using the framework method (exploratory content analysis) combining inductive and deductive approaches.

Results: Overarching themes of data use, data reservations and digital tools acceptance factors were identified. Respondents highlighted several uses for polypharmacy analytics interventions, including increased knowledge of clinical effects of drug-drug interactions, the ability to priorities high-risk patients for reviews and medication to deprescribing (e.g., highlighting cumulative medication risk). Data reservations were linked to existing barriers (such as cognitive overload from existing systems and patient explainability) meaning that CPs’ acceptance of digital analytics tools is heavily contingent on facilitators such as ease of use, clear targeted purpose and the ability to support clinicians’ understanding and confidence in evaluation of analytics for patient care decisions.

Conclusion: The workshop helped to identify promising analytics and features for polypharmacy intervention development. Patient record data could help address a concerning deficit in evidence of real-world medication interactions, and help clinicians prioritize medication reviews. Barriers to use of digital tools for novel analytics must be addressed and criteria for acceptable user-focused tools are suggested.