Implementing evidence-based anticoagulant prescribing: User-centered design findings and recommendations.
Implementing evidence-based anticoagulant prescribing: User-centered design findings and recommendations.
复制标题
DOI：
10.1002/rth2.12803
复制
发表时间：
2022-08
影响因子：
4.6
通讯作者：
Barnes, Geoffrey D.
中科院分区：
文献类型：
--
作者：
Seagull, F. Jacob;Lanham, Michael S.;Pomorski, Michelle;Callahan, Mollie;Jones, Elizabeth K.;Barnes, Geoffrey D.
关键词：
直接口服抗凝剂（DOAC）是广泛使用的药物，具有不可接受的高处方错误率，并且是药物不良事件的主要原因。临床决策支持，包括药物警报，可以是一种有效的实施策略，以减少处方错误，但质量往往是不一致的。以用户为中心的设计（UCD）方法可以提高警报的有效性。通过UCD设计有效的DOAC处方警报，并制定一套可推广的设计建议。本研究使用了一个迭代的UCD过程与执业临床医生。在三个快速迭代设计和评估阶段中，使用测试电子健康记录（EHR）环境和模拟患者创建并完善了原型警报设计。我们在所有用户观察和访谈中确定了关键的新兴主题。主题和最终设计用于推导出一套设计指南。我们的UCD样本包括13名处方医生，包括高级实践提供者，培训医生，初级保健医生和心脏病专家。由此产生的警报设计体现了我们的设计建议，其中包括建立预期适应症，澄清肾功能给药，定制药物相互作用中的警报语言，促进对警报的信任，并最大限度地减少交互开销。通过一个强大的UCD过程，我们已经确定了实施药物警报的关键建议，旨在改善基于证据的DOAC处方。这些建议可能适用于任何EHR系统中DOAC警报的实施。
Direct oral anticoagulants (DOACs) are widely used medications with an unacceptably high rate of prescription errors and are a leading cause of adverse drug events. Clinical decision support, including medication alerts, can be an effective implementation strategy to reduce prescription errors, but quality is often inconsistent. User‐centered design (UCD) approaches can improve the effectiveness of alerts. To design effective DOAC prescription alerts through UCD and develop a set of generalizable design recommendations This study used an iterative UCD process with practicing clinicians. In three rapid iterative design and assessment stages, prototype alert designs were created and refined using a test electronic health record (EHR) environment and simulated patients. We identified key emergent themes across all user observations and interviews. The themes and final designs were used to derive a set of design guidelines. Our UCD sample comprised 13 prescribers, including advanced practice providers, physicians in training, primary care physicians, and cardiologists. The resulting alert designs embody our design recommendations, which include establishing intended indication, clarifying dosing by renal function, tailoring alert language in drug interactions, facilitating trust in alerts, and minimizing interaction overhead. Through a robust UCD process, we have identified key recommendations for implementing medication alerts aimed at improving evidence‐based DOAC prescribing. These recommendations may be applicable to the implementation of DOAC alerts in any EHR systems.
登录
查看更多内容
影响因子：
5.9
作者：
Melton, Brittany L.;Zillich, Alan J.;Russ, Alissa L.
通讯作者：
Russ, Alissa L.
影响因子：
2.7
作者：
Tolley, Clare L.;Slight, Sarah P.;Bates, David W.
通讯作者：
Bates, David W.
DOI：
10.1093/jamia/ocv050
发表时间：
2015-11-01
影响因子：
6.4
作者：
Ratwani, Raj M.;Fairbanks, Rollin J.;Benda, Natalie C.
通讯作者：
Benda, Natalie C.
影响因子：
3.4
作者：
Damoiseaux-Volman, Birgit A.;Medlock, Stephanie;van der Meulen, Delanie M.;de Boer, Jesse;Romijn, Johannes A.;van der Velde, Nathalie;Abu-Hanna, Ameen
通讯作者：
Abu-Hanna, Ameen
DOI：
10.1197/jamia.m2334
发表时间：
2007-03-01
影响因子：
6.4
作者：
Osheroff, Jerome A.;Teich, Jonathan M.;Detmer, Don E.
通讯作者：
Detmer, Don E.