Barriers to Utilization of Prescription Drug Monitoring Programs Among Prescribing Physicians and Advanced Practice Registered Nurses at Veterans Health Administration Facilities in Oregon
Barriers to Utilization of Prescription Drug Monitoring Programs Among Prescribing Physicians and Advanced Practice Registered Nurses at Veterans Health Administration Facilities in Oregon
复制标题
DOI：
10.1093/pm/pnz289
复制
发表时间：
2020-04-01
期刊：
影响因子：
3.1
通讯作者：
Carlson, Kathleen F.
中科院分区：
文献类型：
--
作者：
Mastarone, Ginnifer L.;Wyse, Jessica J.;Carlson, Kathleen F.
Objective.确定俄勒冈州各种退伍军人健康管理局（VA）环境中处方医生和高级执业注册护士使用州处方药监测计划（PDMP）的障碍。设计2018年，对25名VA处方者进行了面对面和基于电话的定性访谈和用户体验评估，探讨了使用州PDMP的障碍。设置.俄勒冈州的VA医疗保健设施。科目医生（N = 11）和高级执业注册护士（N = 14），他们开了预定的药物，为接受阿片类药物的患者提供护理，并在其临床实践中使用PDMP。处方医生驻扎在VA医疗中心（N = 10）和社区门诊（N = 15）;医学专科包括初级保健（N = 10）、心理健康（N = 9）和急诊医学（N = 6）。方法.使用描述性统计分析用户体验。定性访谈采用传统的内容分析方法进行分析。结果大多数医生（64%）和高级执业注册护士（79%）将PDMP评为“有用”。“然而，与会者认为组织和软件设计问题是他们有效使用PDMP的障碍。组织障碍包括时间限制，临床团队成员无法访问，以及查询PDMP相对于其他紧迫临床任务的优先级不明确。设计障碍包括难以输入或记住密码、不可读的数据格式、耗时的程序导航以及无法跨州访问患者信息。结论.不同VA环境中的医生和高级执业注册护士报告称，PDMP是一种重要工具，有助于患者安全。然而，有关组织过程和软件设计的问题阻碍了这些资源的最佳利用。
Objective. To identify barriers to using state prescription drug monitoring programs (PDMPs) among prescribing physicians and advanced practice registered nurses across a variety of Veterans Health Administration (VA) settings in Oregon. Design. In-person and telephone-based qualitative interviews and user experience assessments conducted with 25 VA prescribers in 2018 probed barriers to use of state PDMPs. Setting. VA health care facilities in Oregon. Subjects. Physicians (N = 11) and advanced practice registered nurses (N = 14) who prescribed scheduled medications, provided care to patients receiving opioids, and used PDMPs in their clinical practice. Prescribers were stationed at VA medical centers (N = 10) and community-based outpatient clinics (N = 15); medical specialties included primary care (N = 10), mental health (N = 9), and emergency medicine (N = 6). Methods. User experience was analyzed using descriptive statistics. Qualitative interviews were analyzed using conventional content analysis methodology. Results. The majority of physicians (64%) and advanced practice registered nurses (79%) rated PDMPs as "useful." However, participants identified both organizational and software design issues as barriers to their efficient use of PDMPs. Organizational barriers included time constraints, clinical team members without access, and lack of clarity regarding the priority of querying PDMPs relative to other pressing clinical tasks. Design barriers included difficulties entering or remembering passwords, unreadable data formats, time-consuming program navigation, and inability to access patient information across state lines. Conclusions. Physicians and advanced practice registered nurses across diverse VA settings reported that PDMPs are an important tool and contribute to patient safety. However, issues regarding organizational processes and software design impede optimal use of these resources.