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Publication Date: 2014
Publication Name: Research in Social and Administrative Pharmacy
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Development of a computerised decisions support system for renal risk drugs targeting primary healthcaremore
by Pia Bastholm-rahmner and Ulf Bergman
To assess general practitioners (GPs) experience from the implementation and use of a renal computerised decision support system (CDSS) for drug dosing, developed for primary healthcare, integrated into the patient's electronic health... more
To assess general practitioners (GPs) experience from the implementation and use of a renal computerised decision support system (CDSS) for drug dosing, developed for primary healthcare, integrated into the patient's electronic health record (EHR), and building on estimation of the patient's creatinine clearance (ClCG). Qualitative research design by a questionnaire and a focus group discussion. Eight GPs at two primary healthcare centres (PHCs). The GP at PHC 1, and the project group, developed and tested the technical solution of the CDSS. Proof-of-concept was tested by seven GPs at PHC 2. They also participated in a group discussion and answered a questionnaire. A web window in the EHR gave drug and dosage in relation to ClCG. Each advice was according to three principles: If? Why? Because. (1) The GPs' experience of 'easiness to use' and 'perceived usefulness' at PHC 2, based on loggings of use, answers from a questionnaire using a 5-point Likert scal...
Publication Date: 2015
Publication Name: BMJ open
Research Interests:
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Publication Date: 2014
Publication Name: International Journal of Medical Informatics
Research Interests: Engineering, Information Technology, Technology, Medical Informatics, Research Methodology, and 28 morePrimary Health Care, Behavior, Developing Countries, Qualitative Research, Health, Information Processing, Motivation, Information, Information Services, Rural Health, Interviews, Pregnancy, Humans, Burkina Faso, Female, Male, Attitudes, CDSS, Needs, Data Collection, Middle Aged, Adult, Clinical Decision Support System, ANC, IT, Clinical Decision Support Systems, Prenatal Care, and Health Personnel(Primary Health Care, Behavior, Developing Countries, Qualitative Research, Health, Information Processing, Motivation, Information, Information Services, Rural Health, Interviews, Pregnancy, Humans, Burkina Faso, Female, Male, Attitudes, CDSS, Needs, Data Collection, Middle Aged, Adult, Clinical Decision Support System, ANC, IT, Clinical Decision Support Systems, Prenatal Care, and Health Personnel)
(Primary Health Care, Behavior, Developing Countries, Qualitative Research, Health, Information Processing, Motivation, Information, Information Services, Rural Health, Interviews, Pregnancy, Humans, Burkina Faso, Female, Male, Attitudes, CDSS, Needs, Data Collection, Middle Aged, Adult, Clinical Decision Support System, ANC, IT, Clinical Decision Support Systems, Prenatal Care, and Health Personnel)
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Publication Date: 2013
Publication Name: The International Journal of Health Planning and Management
Research Interests:
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A cross-sectional pilot study assessing needs and attitudes to implementation of Information and Communication Technology for rational use of medicines among healthcare staff in rural Tanzaniamore
by Amos Nungu and Pia Bastholm-rahmner
In resource-poor countries access to essential medicines, suboptimal prescribing and use of medicines are major problems. Health workers lack updated medical information and treatment support. Information and Communication Technology... more
In resource-poor countries access to essential medicines, suboptimal prescribing and use of medicines are major problems. Health workers lack updated medical information and treatment support. Information and Communication Technology (ICT) could help tackle this. The impact of ICT on health systems in resource-poor countries is likely to be significant and transform the practice of medicine just as in high-income countries. However, research for finding the best way of doing this is needed. We aimed to assess current approaches to and use of ICT among health workers in two rural districts of Tanzania in relation to the current drug distribution practices, drug stock and continuing medical information (CME), as well as assessing the feasibility of using ICT to improve ordering and use of medicines. This pilot study was conducted in 2010-2011, mapping the drug distribution chain in Tanzania, including problems and barriers. The study was conducted in Bunda and Serengeti districts, bot...
Publication Date: 2014
Publication Name: BMC medical informatics and decision making
Research Interests:
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To develop and verify proof of concept for a clinical decision support system (CDSS) to support prescriptions of pharmaceutical drugs in patients with reduced renal function, integrated in an electronic health record system (EHR) used in... more
To develop and verify proof of concept for a clinical decision support system (CDSS) to support prescriptions of pharmaceutical drugs in patients with reduced renal function, integrated in an electronic health record system (EHR) used in both hospitals and primary care. A pilot study in one geriatric clinic, one internal medicine admission ward and two outpatient healthcare centers was evaluated with a questionnaire focusing on the usefulness of the CDSS. The usage of the system was followed in a log. The CDSS is considered to increase the attention on patients with impaired renal function, provides a better understanding of dosing and is time saving. The calculated glomerular filtration rate (eGFR) and the dosing recommendation classification were perceived useful while the recommendation texts and background had been used to a lesser extent. Few previous systems are used in primary care and cover this number of drugs. The global assessment of the CDSS scored high but some elements...
Publication Date: Jan 21, 2015
Publication Name: International journal of medical informatics
Research Interests:
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Relevant and easily accessible drug information at point-of-care is essential for physicians' decision making when prescribing. However, the... more
Relevant and easily accessible drug information at point-of-care is essential for physicians' decision making when prescribing. However, the information available by using Clinical Decision Support Systems (CDSSs) often does not meet physicians' requirements. The Summary of Product Characteristics (SmPC) is statutory information about drugs. However, the current structure, content and format of SmPCs make it difficult to incorporate them into CDSSs and link them to relevant patient information from the Electronic Health Records. The aim of the study was to evaluate the perceived needs for drug information among physicians in Sweden. We recruited three focus group discussions with 18 physicians covering different specialities. The information from the groups was combined with a questionnaire administered at the beginning of the group discussions. Physicians reported their needs for knowledge databases at the point of drug prescribing. This included more consistent information about existing and new drugs. They also wished to receive automatically generated alerts for severe drug-drug interactions and adverse effects, and to have functions for calculating glomerular filtration rate to enable appropriate dose adjustments to be made for elderly patients and those with impaired renal function. Additionally, features enhancing electronic communication with colleagues and making drug information more searchable were suggested. The results from the current study showed the need for knowledge databases which provide consistent information about new and existing drugs. Most of the required information from physicians appeared to be possible to transfer from current SmPCs to CDSSs. However, inconsistencies in the SmPC information have to be reduced to enhance their utility.
Publication Date: 2012
Publication Name: British Journal of Clinical Pharmacology
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