一个NASSSS框架引导的系统审查和探索性建模数字健康干预措施,用于多药店管理的老年人
Arun Vamadevan1,2,3,4, Vijesh Vijayan5, Christine Cole6
1NIHR Clinical Research Facility, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK. arun.vamadevan@liverpoolft.nhs.uk.
BMC geriatrics
|November 22, 2025
概括
技术支持的干预措施可以优化老年人药物使用,但面临采用挑战. 以用户为中心的设计,临床领导力和适应能力是成功实施和可持续性的关键.
科学领域:
- 老年学是一门学科.
- 医疗信息学 医疗信息学
- 制药科学 制药科学
背景情况:
- 老年人多种疾病多种药物治疗对老年人多种疾病多种药物治疗带来了重大的医疗保健挑战,包括不良药物事件和住院病例增加.
- 技术支持的干预措施,如临床决策支持系统 (CDSS) 和数字减压工具,为药物优化提供了潜在的解决方案.
- 非采用,放弃,扩大,扩散和可持续性 (NASSS) 框架为评估这些复杂的数字健康干预提供了一个结构化的方法.
研究的目的:
- 系统地审查技术支持药物优化干预措施的采用,扩展和可持续性.
- 应用NASSS框架来指导对这些干预措施的审查.
- 确定影响技术支持老年人群药物管理成功的关键因素.
主要方法:
- 在主要数据库 (Scopus,PubMed,Cochrane图书馆,CINAHL) 进行了系统的文献搜索.
- 包括选和资格评估后的30项研究,执行与NASSSS领域映射的叙事合成.
- 采用探索性预测建模,包括决策树分析,以确定技术支持药物优化的成功因素.
主要成果:
- 成功采用干预措施 (CDSS,数字抑郁症) 与以用户为中心的设计,临床领导,工作流集成和组织准备度有关.
- 通过多学科合作,持续反和代适应来增强可持续性; 常见的障碍包括技术复杂性和缺乏提供商参与.
- 决策树分析强调了可用性,早期利益相关者参与,组织调整和系统适应性作为成功采用和可持续性的关键预测因素.
结论:
- 本次审查独特地将NASSSS框架与决策树建模相结合,用于评估老年人技术支持药物优化.
- 成功实施需要一个形成性的,情境敏感的方法来解决技术,组织和政策的复杂性.
- 研究结果强调了一项整体战略的重要性,以优化多药老年患者的药物管理.
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