Reliability and Feasibility Assessment of EldenCare: A Geriatric Clinical Decision Support System Pilot Study

Medication safety is a critical concern in geriatric care, with high rates of polypharmacy and potentially inappropriate medications among older adult patients in India. The EldenCare application was developed as a digital clinical decision support tool to address these challenges through evidence-based screening and collaborative medication management.

To evaluate the reliability and feasibility of the EldenCare system in supporting safe medication practices among older adults.

This prospective observational study was conducted over 10 days with 22 healthcare professionals and 15 simulated patient profiles. Reliability assessment included the validation of automated clinical calculations (creatinine clearance and glomerular filtration rate) and the evaluation of drug-related problem (DRP) detection. Feasibility was measured using the System Usability Scale (SUS), AttrakDiff Mini questionnaire, and Technology Acceptance Model. A companion mobile application was also evaluated by 15 Android users based on 11 key features.

The EldenCare system received positive usability ratings (SUS: 72.82 ± 9.83) and high acceptance scores (perceived usefulness: 5.86 ± 0.65; perceived ease of use: 6.02 ± 0.60) from healthcare professionals, with no significant differences between physicians and clinical pharmacists (P > .05). However, significant technical limitations were identified: (1) none of the 25 test cases for clinical calculations fell within the acceptable ±2% error margin; (2) DRP detection showed inadequate accuracy across all categories (53.42% overall, range: 61.64% to 76.02%, all below the predetermined 95% threshold); and (3) the patient mobile application's medication and appointment reminder notifications failed after 3 days.

EldenCare shows promising potential through high user acceptance but requires substantial technical refinement before clinical implementation. Future development should focus on algorithm accuracy, medication database mapping, and notification reliability to enhance medication safety in older adults.