Development and evaluation of a patient-centric approach for accurate medication capture

To develop and evaluate a patient-centric medication module within a personal health record (PHR) app for capturing medication use, focusing on accuracy, usability, and concordance.

The medication module offered 4 entry methods: picklist, National Drug Code (NDC), free-text, and portal import, with the first 2 leveraging RxNorm and openFDA APIs. Patients from an integrated delivery network (IDN) created medication lists and recorded daily use in the app's diary. Pharmacists evaluated medication accuracy by reviewing patient-uploaded medication images. Usability was measured using the System Usability Scale (SUS). Concordance was assessed by comparing Electronic Health Records (EHR) with diary entries.

Over a 14-day period, 85 patients entered 617 medications, with 533 logged in the diary representing current use. Picklist was the most used entry method. Overall medication entry accuracy was 92% (picklist 97%; NDC 87%; free-text 84%; and portal import 100%). The mean system usability score was 56.5 for the study app (patients) and 80.8 for the medication module (pharmacists). EHR concordance with diary entries was low (25% using the 14-day window; 53% using a 1-year window); most unmatched entries were over-the-counter (OTC) medications.

Accurate and complete medication records are essential for the safe and effective use of medications. This patient-centric medication module supported accurate capture of prescription and OTC medications. Gaps in EHR data highlight the need to improve medication record accuracy and reconciliation.

Patient-generated health data can have a central role in creating the "Best Possible Medication History" envisioned by the World Health Organization.