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Computerized Decision Support Improves Medication Review Effectiveness: An Experiment Evaluating the STRIP
Michiel C Meulendijk1, Marco R Spruit, A Clara Drenth-van Maanen
1Department of Information and Computing Sciences, Utrecht University, Princetonplein 5, 3584 CC, Utrecht, The Netherlands, m.c.meulendijk@uu.nl.
The STRIP Assistant enhances medication reviews for polypharmacy patients, improving appropriate prescribing decisions. While it increases time spent on reviews, it significantly boosts overall effectiveness in optimizing patient drug regimens.
Area of Science:
- Geriatrics
- Pharmacology
- Health Informatics
Background:
- Polypharmacy presents significant risks to patient health.
- The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) is a method for medication review in primary care.
- The STRIP Assistant is a decision support system designed to aid physicians in pharmacotherapeutic analysis.
Purpose of the Study:
- To validate the usability of the STRIP Assistant for physicians managing polypharmacy patients.
- To assess the tool's effectiveness and efficiency in optimizing medication records.
Main Methods:
- An online experiment involved 42 physicians optimizing patient records.
- Physicians used the STRIP Assistant for one patient and their usual method for another.
- Effectiveness was measured against expert recommendations; efficiency by time taken; satisfaction by SUS scores.
Main Results:
- The STRIP Assistant significantly improved medication optimization effectiveness (58% to 76% appropriate decisions).
- Inappropriate decisions decreased from 42% to 24% with the tool (p < 0.0001).
- Physicians spent more time (24 min vs. 13 min) using the STRIP Assistant, with a below-average SUS score of 63.25.
Conclusions:
- The STRIP Assistant demonstrably enhances the effectiveness of medication reviews for patients with polypharmacy.
- The tool aids in optimizing drug regimens, leading to better prescribing practices.
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