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Usability of an app-based clinical decision support system to monitor psychotropic drug prescribing appropriateness in dementia
Rasing N, Janus S, Smalbrugge M, Koopmans R, Zuidema S.. International journal of medical informatics, 2023-06-21
Topic: Risk, prevention and care in population studies
Plain-language summary
Background Guidelines recommend reluctant psychotropic drug (PD) prescribing in nursing home residents with dementia and neuropsychiatric symptoms (NPS), as efficacy of PDs is limited, and side effects are common. Nevertheless, PDs are commonly prescribed to reduce NPS. A smartphone application that evaluates appropriateness of PD prescriptions and provides recommendations from the revised Dutch guideline on problem behaviour in dementia may promote guideline adherence and increase appropriate prescribing. Objective This study aimed to assess user experiences, barriers and facilitators of the Dutch 'Psychotropic Drug Tool' smartphone application (PDT) in the context of appropriate prescribing of PDs to nursing home residents with dementia and NPS. Methods/design The PDT was developed according to the recommendations of the Dutch guideline for treatment of NPS in people with dementia. Feedback provided during usability testing with two end-users was applied to improve the PDT before implementation in day-to-day practice. Sixty-three prescribers were asked to use the PDT at their own convenience for four months. User expectations and experiences were assessed at baseline and after four months with the System Usability Scale and the Assessment of Barriers and Facilitators for Implementation. Results Expected usability (M = 72.59; SD = 11.84) was similar to experienced usability after four months (M = 69.13; SD = 16.48). Appreciation of the PDTs user-friendliness (on average 6.7 out of 10) and design (7.3) were moderately positive, in contrast to the global rating of the PDT (5.7). Perceived barriers for PDT use were time consumption and lack of integration with existing electronic systems. Perceived facilitators were ease of use and attractive lay out. For broader implementation, physicians suggested a change in direction of the PDT: start assessment of appropriateness based on the list of NPS instead of PD as primary input. Conclusions In this pragmatic prospective cohort study we found that the PDT was used by elderly care physicians, with mediocre user satisfaction. The PDT will be optimized based on user feedback regarding experienced usability, barriers and facilitators, after which broader implementation can be initialized. The Medical Ethics Review Board of the University Medical Center Groningen declared this is a non-WMO study (UMCG RR Number: 201800284).
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APA 7th
Rasing, N., Janus, S., Smalbrugge, M., Koopmans, R., & Zuidema, S. (2023). Usability of an app-based clinical decision support system to monitor psychotropic drug prescribing appropriateness in dementia. International journal of medical informatics. https://doi.org/10.1016/j.ijmedinf.2023.105132
Vancouver
Rasing N, Janus S, Smalbrugge M, Koopmans R, Zuidema S. Usability of an app-based clinical decision support system to monitor psychotropic drug prescribing appropriateness in dementia. International journal of medical informatics. 2023. doi:10.1016/j.ijmedinf.2023.105132. PMID: 37364356.
BibTeX
@article{rasing2023-37364356,
author = {Rasing, N. and Janus, S. and Smalbrugge, M. and Koopmans, R. and Zuidema, S.},
title = {{Usability of an app-based clinical decision support system to monitor psychotropic drug prescribing appropriateness in dementia}},
journal = {International journal of medical informatics},
year = {2023},
doi = {10.1016/j.ijmedinf.2023.105132},
pmid = {37364356},
url = {https://doi.org/10.1016/j.ijmedinf.2023.105132}
}
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Key findings
- Results Expected usability (M = 72.59; SD = 11.84) was similar to experienced usability after four months (M = 69.13; SD = 16.48).
- Conclusions In this pragmatic prospective cohort study we found that the PDT was used by elderly care physicians, with mediocre user satisfaction.
Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 55/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 32 of the 58 points we could judge it on, which is 55 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International journal of medical informatics) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 37364356) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 32 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 32 of the 58 points we could judge it on is 55 out of 100. |
| Total | 55 / 100 | — |
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