TY  - JOUR
A1  - Brünn, Robin
A1  - Lemke, Dorothea
A1  - Basten, Jale
A1  - Kellermann-Mühlhoff, Petra
A1  - Köberlein-Neu, Juliane
A1  - Muth, Christiane
A1  - Akker, Marjan van den
T1  - Use of an electronic medication management support system in patients with polypharmacy in general practice: a quantitative process evaluation of the AdAM trial
T2  - Pharmaceuticals
N2  - Polypharmacy is associated with a risk of negative health outcomes. Potentially inappropriate medications, interactions resulting from contradicting medical guidelines, and inappropriate monitoring, all increase the risk. This process evaluation (PE) of the AdAM study investigates implementation and use of a computerized decision-support system (CDSS). The CDSS analyzes medication appropriateness by including claims data, and hence provides general practitioners (GPs) with full access to patients’ medical treatments. We based our PE on pseudonymized logbook entries into the CDSS and used the four dimensions of the Medical Research Council PE framework. Reach, which examines the extent to which the intended study population was included, and Dose, Fidelity, and Tailoring, which examine how the software was actually used by GPs. The PE was explorative and descriptive. Study participants were representative of the target population, except for patients receiving a high level of nursing care, as they were treated less frequently. GPs identified and corrected inappropriate prescriptions flagged by the CDSS. The frequency and intensity of interventions documented in the form of logbook entries lagged behind expectations, raising questions about implementation barriers to the intervention and the limitations of the PE. Impossibility to connect the CDSS to GPs’ electronic medical records (EMR) of GPs due to technical conditions in the German healthcare system may have hindered the implementation of the intervention. Data logged in the CDSS may underestimate medication changes in patients, as documentation was voluntary and already included in EMR.
KW  - polypharmacy
KW  - medication review
KW  - digital decision-support
KW  - health services research
KW  - general practice
KW  - process evaluation
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/73496
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-734967
SN  - 1424-8247
N1  - This research was funded by INNOVATIONSONDS NEUE VERSORGUNGSFORMEN (Innovation Fund of the German Federal Joint Committee), grant number 01NVF16006. The APC was funded by the open access publication fund of Goethe University, Frankfurt am Main, Germany.
N1  - The data presented in this study are available on request from the corresponding author. The data are not publicly available due to data protection regulations.
VL  - 15
IS  - 6, art. 759
SP  - 1
EP  - 19
PB  - MDPI
CY  - Basel
ER  -