Digital Solutions to Improve Medication Management

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 26024

Special Issue Editors


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Guest Editor
Faculty of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway
Interests: quality and safety in medication management; electronic medication management systems; information technology; patient safety; health outcomes

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Guest Editor
1. Norwegian Centre for E-health Research, University Hospital of North Norway, 9038 Tromsø, Norway
2. Faculty of Pharmacy, UiT The Arctic University of Norway, 9037 Tromsø, Norway
Interests: E-health innovation and research; electronic medicine management; quality and safety in health and care services; patient outcomes; efficiency and economics

Special Issue Information

Dear Colleagues,

Medication management is a complex process that comprises the decision to prescribe, the selection of appropriate medication, prescribing, dosing, procurement, storage, preparation, dispensing, administration, monitoring, evaluation, and education. Digital solutions may increase task efficiency and improve quality, but can cause workarounds and unintended consequences that jeopardize patient safety. Examples of digital solutions to improve medication management include, among others, electronic prescribing, having a shared medication list, closed loop medication, clinical decision support, automated dispensing, and administration reminders.

There is an abundance of digital solutions available for patients, carers, and clinicians to use in order to improve medication management. However, many of these solutions lack robust evidence to support claims of improved outcomes.

We invite you to share you research on the design or evaluation of digital solutions to improve medication management in primary care settings, nursing homes, hospitals, or pharmacies. Of special interest are digital solutions for improved medication management for the growing number of people receiving home health care. These solutions can be stand alone or be incorporated into existing systems, or a consumer-facing solution such as an app.

Assoc. Prof. Elin Lehnbom
Assoc. Prof. Trine Strand Bergmo
Guest Editors

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Keywords

  • Digital solutions;
  • Medication management;
  • Electronic prescribing;
  • Shared medication list;
  • Adherence;
  • Medication safety;
  • Patient safety;
  • Medication errors.

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Published Papers (5 papers)

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Research

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15 pages, 245 KiB  
Article
Challenges Faced by Health Professionals in Obtaining Correct Medication Information in the Absence of a Shared Digital Medication List
by Unn Sollid Manskow and Truls Tunby Kristiansen
Pharmacy 2021, 9(1), 46; https://doi.org/10.3390/pharmacy9010046 - 22 Feb 2021
Cited by 6 | Viewed by 5721
Abstract
Information about patient medication use is usually registered and stored in different digital systems, making it difficult to share information across health care organisations. The lack of digital systems able to share medication information poses a threat to patient safety and quality of [...] Read more.
Information about patient medication use is usually registered and stored in different digital systems, making it difficult to share information across health care organisations. The lack of digital systems able to share medication information poses a threat to patient safety and quality of care. We explored the experiences of health professionals with obtaining and exchanging information on patient medication lists in Norwegian primary health care within the context of current digital and non-digital solutions. We used a qualitative research design with semi-structured interviews, including general practitioners (n = 6), pharmacists (n = 3), nurses (n = 17) and medical doctors (n = 6) from six municipalities in Norway. Our findings revealed the following five challenges characterised by being cut off from information on patient medication lists in the current digital and non-digital solutions: ‘fragmentation of information systems’, ‘perceived risk of errors’, ‘excessive time use’, ‘dependency on others’ and ‘uncertainty’. The challenges were particularly related to patient transitions between levels of care. Our study shows an urgent need for digital solutions to ensure seamless, up-to-date information about patient medication lists in order to prevent medication-related problems. Future digital solutions for a shared medication list should address these challenges directly to ensure patient safety and quality of care. Full article
(This article belongs to the Special Issue Digital Solutions to Improve Medication Management)
12 pages, 254 KiB  
Article
From Paper to E-Prescribing of Multidose Drug Dispensing: A Qualitative Study of Workflow in a Community Care Setting
by Anette Vik Josendal and Trine Strand Bergmo
Pharmacy 2021, 9(1), 41; https://doi.org/10.3390/pharmacy9010041 - 16 Feb 2021
Cited by 7 | Viewed by 5991
Abstract
E-prescribing is now widespread and, in some countries, has completely replaced paper prescriptions. In Norway, almost all prescribing is electronic, except for multidose drug dispensing (MDD), which is still sent to the pharmacy by fax or ordinary mail. MDD is an adherence aid [...] Read more.
E-prescribing is now widespread and, in some countries, has completely replaced paper prescriptions. In Norway, almost all prescribing is electronic, except for multidose drug dispensing (MDD), which is still sent to the pharmacy by fax or ordinary mail. MDD is an adherence aid used by one-third of all patients receiving home care services. In this paper, we present results from a qualitative study evaluating the introduction of e-prescribing for MDD in a community health care setting. The focus is on the work and workflow for the pharmacists and nurses involved in the medication-handling process. We used the pragmatic process evaluation framework and the systematic text condensation method to analyse the data. We conducted 12 interviews with 34 nurses and pharmacists. This study shows that the e-prescribing of MDD led to greater integration between systems, both within the existing MDD system and across care levels, potentially improving patient safety. However, the structured prescriptions increased the need for clarifications, resulting in an increased overall workload. A greater understanding of the roles and responsibilities of the different professionals in the medication management chain and their needs would improve the workflow of the nurses and pharmacists involved. Full article
(This article belongs to the Special Issue Digital Solutions to Improve Medication Management)
13 pages, 795 KiB  
Article
Patients’ Use and Perceptions of a Drug-Drug Interaction Database: A Survey of Janusmed Interactions
by Hanna Justad, Ylva Askfors, Tero Shemeikka, Marine L. Andersson and Tora Hammar
Pharmacy 2021, 9(1), 23; https://doi.org/10.3390/pharmacy9010023 - 19 Jan 2021
Cited by 6 | Viewed by 3471
Abstract
Janusmed interactions is a drug-drug interactions (DDI) database available online for healthcare professionals (HCP) at all levels of the healthcare system including pharmacies. The database is aimed at HCP but is also open to the public for free, for those individuals who register [...] Read more.
Janusmed interactions is a drug-drug interactions (DDI) database available online for healthcare professionals (HCP) at all levels of the healthcare system including pharmacies. The database is aimed at HCP but is also open to the public for free, for those individuals who register for a personal account. The aim of this study was to investigate why and how patients use the database Janusmed interactions, how they perceive content and usability, and how they would react if they found an interaction. A web-based questionnaire was sent by email to all users who had registered for Janusmed interactions as a “patient” (n = 3219). A total of 406 patients completed the survey (response rate 12.6%). The study shows that there is an interest among patients to use a DDI database to check their own or a relative’s medication. The respondents found the database easy to use and perceive they understand the information aimed at HCP. Most patients stated they would talk to their HCP if they found an interaction and not adjust their treatment by themselves. However, the respondents in this study are actively searching for information and seem to have high health literacy. Thus, the findings are not generalizable for the general population. Full article
(This article belongs to the Special Issue Digital Solutions to Improve Medication Management)
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9 pages, 1165 KiB  
Communication
Shaping the Future of Digitally Enabled Health and Care
by Maureen Spargo, Nicola Goodfellow, Claire Scullin, Sonja Grigoleit, Andreas Andreou, Constandinos X. Mavromoustakis, Bárbara Guerra, Marco Manso, Nekane Larburu, Óscar Villacañas, Glenda Fleming and Michael Scott
Pharmacy 2021, 9(1), 17; https://doi.org/10.3390/pharmacy9010017 - 12 Jan 2021
Cited by 6 | Viewed by 4267
Abstract
People generally need more support as they grow older to maintain healthy and active lifestyles. Older people living with chronic conditions are particularly dependent on healthcare services. Yet, in an increasingly digital society, there is a danger that efforts to drive innovations in [...] Read more.
People generally need more support as they grow older to maintain healthy and active lifestyles. Older people living with chronic conditions are particularly dependent on healthcare services. Yet, in an increasingly digital society, there is a danger that efforts to drive innovations in eHealth will neglect the needs of those who depend on healthcare the most—our ageing population. The SHAPES (Smart and Healthy Ageing through People Engaging in Supportive Systems) Innovation Action aims to create an open European digital platform that facilitates the provision of meaningful, holistic support to older people living independently. A pan-European pilot campaign will evaluate a catalogue of digital solutions hosted on the platform that have been specifically adapted for older people. ‘Medicines control and optimisation’ is one of seven themes being explored in the campaign and will investigate the impact of digital solutions that aim to optimise medicines use by way of fostering effective self-management, while facilitating timely intervention by clinicians based on remote monitoring and individualised risk assessments powered by artificial intelligence. If successful, the SHAPES Innovation Action will lead to a greater sense of self-sufficiency and empowerment in people living with chronic conditions as they grow older. Full article
(This article belongs to the Special Issue Digital Solutions to Improve Medication Management)
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Review

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18 pages, 323 KiB  
Review
Current Knowledge about Providing Drug–Drug Interaction Services for Patients—A Scoping Review
by Tora Hammar, Sara Hamqvist, My Zetterholm, Päivi Jokela and Mexhid Ferati
Pharmacy 2021, 9(2), 69; https://doi.org/10.3390/pharmacy9020069 - 24 Mar 2021
Cited by 14 | Viewed by 5105
Abstract
Drug–drug interactions (DDIs) pose a major problem to patient safety. eHealth solutions have the potential to address this problem and generally improve medication management by providing digital services for health care professionals and patients. Clinical decision support systems (CDSS) to alert physicians or [...] Read more.
Drug–drug interactions (DDIs) pose a major problem to patient safety. eHealth solutions have the potential to address this problem and generally improve medication management by providing digital services for health care professionals and patients. Clinical decision support systems (CDSS) to alert physicians or pharmacists about DDIs are common, and there is an extensive body of research about CDSS for professionals. Information about DDIs is commonly requested by patients, but little is known about providing similar support to patients. The aim of this scoping review was to explore and describe current knowledge about providing digital DDI services for patients. Using a broad search strategy and an established framework for scoping reviews, 19 papers were included. The results show that although some patients want to check for DDIs themselves, there are differences between patients, in terms of demands and ability. There are numerous DDI services available, but the existence of large variations regarding service quality implies potential safety issues. The review includes suggestions about design features but also indicates a substantial knowledge gap highlighting the need for further research about how to best design and provide digital DDI to patients without risking patient safety or having other unintended consequences. Full article
(This article belongs to the Special Issue Digital Solutions to Improve Medication Management)
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