Limits...
Computerized Decision Support Improves Medication Review Effectiveness: An Experiment Evaluating the STRIP Assistant's Usability.

Meulendijk MC, Spruit MR, Drenth-van Maanen AC, Numans ME, Brinkkemper S, Jansen PA, Knol W - Drugs Aging (2015)

Bottom Line: Medication optimization significantly improved with the STRIP Assistant.Inappropriate decisions decreased from 42% without the STRIP Assistant to 24% with it (p < 0.0001).Participants spent significantly more time optimizing medication with the STRIP Assistant (24 min) than without it (13 min; p < 0.0001).

View Article: PubMed Central - PubMed

Affiliation: Department of Information and Computing Sciences, Utrecht University, Princetonplein 5, 3584 CC, Utrecht, The Netherlands, m.c.meulendijk@uu.nl.

ABSTRACT

Background: Polypharmacy poses threats to patients' health. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) is a drug optimization process for conducting medication reviews in primary care. To effectively and efficiently incorporate this method into daily practice, the STRIP Assistant--a decision support system that aims to assist physicians with the pharmacotherapeutic analysis of patients' medical records--has been developed. It generates context-specific advice based on clinical guidelines.

Objective: The aim of this study was to validate the STRIP Assistant's usability as a tool for physicians to optimize medical records for polypharmacy patients.

Methods: In an online experiment, 42 physicians were asked to optimize medical records for two comparable polypharmacy patients, one in their usual manner and one using the STRIP Assistant. Changes in effectiveness were measured by comparing respondents' optimized medicine prescriptions with medication prepared by an expert panel of two geriatrician-pharmacologists. Efficiency was operationalized by recording the time the respondents took to optimize the two cases. User satisfaction was measured with the System Usability Scale (SUS). Independent and paired t tests were used for analysis.

Results: Medication optimization significantly improved with the STRIP Assistant. Appropriate decisions increased from 58% without the STRIP Assistant to 76% with it (p < 0.0001). Inappropriate decisions decreased from 42% without the STRIP Assistant to 24% with it (p < 0.0001). Participants spent significantly more time optimizing medication with the STRIP Assistant (24 min) than without it (13 min; p < 0.0001). They assigned it a below-average SUS score of 63.25.

Conclusion: The STRIP Assistant improves the effectiveness of medication reviews for polypharmacy patients.

Show MeSH
The five steps of the Systematic Tool to Reduce Inappropriate Prescribing (STRIP) method, depicted as a yearly repeating cycle
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4469772&req=5

Fig1: The five steps of the Systematic Tool to Reduce Inappropriate Prescribing (STRIP) method, depicted as a yearly repeating cycle

Mentions: Recently, the POM, GIVE, and START and STOPP criteria have been combined into the Systematic Tool to Reduce Inappropriate Prescribing (STRIP), which has consequently been included as part of a Dutch multidisciplinary guideline on polypharmacy in elderly patients [23]. The STRIP has been designed to be an all-encompassing drug optimization process in primary care, focusing not just on pharmacotherapeutic analysis but also on patients’ medication histories and preferences; Fig. 1 shows the STRIP method’s different steps.Fig. 1


Computerized Decision Support Improves Medication Review Effectiveness: An Experiment Evaluating the STRIP Assistant's Usability.

Meulendijk MC, Spruit MR, Drenth-van Maanen AC, Numans ME, Brinkkemper S, Jansen PA, Knol W - Drugs Aging (2015)

The five steps of the Systematic Tool to Reduce Inappropriate Prescribing (STRIP) method, depicted as a yearly repeating cycle
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4469772&req=5

Fig1: The five steps of the Systematic Tool to Reduce Inappropriate Prescribing (STRIP) method, depicted as a yearly repeating cycle
Mentions: Recently, the POM, GIVE, and START and STOPP criteria have been combined into the Systematic Tool to Reduce Inappropriate Prescribing (STRIP), which has consequently been included as part of a Dutch multidisciplinary guideline on polypharmacy in elderly patients [23]. The STRIP has been designed to be an all-encompassing drug optimization process in primary care, focusing not just on pharmacotherapeutic analysis but also on patients’ medication histories and preferences; Fig. 1 shows the STRIP method’s different steps.Fig. 1

Bottom Line: Medication optimization significantly improved with the STRIP Assistant.Inappropriate decisions decreased from 42% without the STRIP Assistant to 24% with it (p < 0.0001).Participants spent significantly more time optimizing medication with the STRIP Assistant (24 min) than without it (13 min; p < 0.0001).

View Article: PubMed Central - PubMed

Affiliation: Department of Information and Computing Sciences, Utrecht University, Princetonplein 5, 3584 CC, Utrecht, The Netherlands, m.c.meulendijk@uu.nl.

ABSTRACT

Background: Polypharmacy poses threats to patients' health. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) is a drug optimization process for conducting medication reviews in primary care. To effectively and efficiently incorporate this method into daily practice, the STRIP Assistant--a decision support system that aims to assist physicians with the pharmacotherapeutic analysis of patients' medical records--has been developed. It generates context-specific advice based on clinical guidelines.

Objective: The aim of this study was to validate the STRIP Assistant's usability as a tool for physicians to optimize medical records for polypharmacy patients.

Methods: In an online experiment, 42 physicians were asked to optimize medical records for two comparable polypharmacy patients, one in their usual manner and one using the STRIP Assistant. Changes in effectiveness were measured by comparing respondents' optimized medicine prescriptions with medication prepared by an expert panel of two geriatrician-pharmacologists. Efficiency was operationalized by recording the time the respondents took to optimize the two cases. User satisfaction was measured with the System Usability Scale (SUS). Independent and paired t tests were used for analysis.

Results: Medication optimization significantly improved with the STRIP Assistant. Appropriate decisions increased from 58% without the STRIP Assistant to 76% with it (p < 0.0001). Inappropriate decisions decreased from 42% without the STRIP Assistant to 24% with it (p < 0.0001). Participants spent significantly more time optimizing medication with the STRIP Assistant (24 min) than without it (13 min; p < 0.0001). They assigned it a below-average SUS score of 63.25.

Conclusion: The STRIP Assistant improves the effectiveness of medication reviews for polypharmacy patients.

Show MeSH