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瑞士初级医疗中药物管理技术的应用:混合方法研究

Using Medication Management Technologies in Swiss Primary Care: Mixed Methods Study.

作者信息

Wildisen Jeanne Maria, Romer Alessia, Zangger Martina, Bugnon Benjamin, Streit Sven, Weir Kristie Rebecca, Jungo Katharina Tabea

机构信息

Institute of Primary Health Care (BIHAM), University of Berne, Berne, Switzerland.

Graduate School for Health Sciences, University of Berne, Berne, Switzerland.

出版信息

J Med Internet Res. 2025 Aug 27;27:e68857. doi: 10.2196/68857.

Abstract

BACKGROUND

Medication management IT, such as shared electronic medication plans (eMediplan) and the Swiss Electronic Patient Record, is increasingly rolled out across Switzerland. They can support primary care physicians and older adults to optimize medication use and reduce medication-related harm. Understanding users' expectations is essential for the implementation of medication management IT in primary care settings.

OBJECTIVE

This study aims to explore primary care physicians' and older adults' experiences and attitudes regarding medication management IT and identify barriers and facilitators to their use.

METHODS

We used a convergent mixed methods design using internet-based questionnaires and semistructured interviews with primary care physicians and older adults in Swiss primary care settings from January to August 2024. Participants included older adults aged ≥60 years who were using ≥2 prescribed medications daily, as well as primary care physicians practicing in Switzerland. Quantitative questionnaire data were analyzed using descriptive statistics to describe current use and attitudes regarding medication management IT. Qualitative data were analyzed using thematic analysis.

RESULTS

A total of 252 older adults (n=126, 50.0% female; mean age 73, SD 7 years) and 46 primary care physicians (n=15, 32.6% female; mean age 54, SD 11 years) completed the questionnaire. Notably, 7/252 (2.8%) older adults and 21/46 (45.7%) physicians reported using shared electronic medication plans. Most older adults reported not using the Swiss Electronic Patient Record (240/252, 95.2%) but expressed willingness to adopt it to manage (164/240, 68.3%) or share (179/240, 74.6%) their health information in the future. Most physicians were open to using digital tools for medication optimization (35/46, 76.1%) or a platform to coordinate medication optimization with patients and other health care providers (29/46, 63.0%). Interviews were conducted with 19 older adults (12/19, 63.2% female; mean age 77, SD 9 years) and 16 physicians (5/16, 31.3% female). The qualitative data helped explain the quantitative findings. Older adults rarely used medication management IT, while physicians mainly used basic tools integrated into their practice information system (eg, interaction checkers). Barriers and facilitators for both groups included information about these novel technologies, accessibility, perceived need and benefit, usability and accessibility, data protection, and required time and effort.

CONCLUSIONS

Although older adults and primary care physicians perceived advantages of medication management IT, current use remains limited. Improving access, usability, and training for all stakeholders may facilitate broader adoption and enhance medication safety in interprofessional primary care settings.

摘要

背景

药物管理信息技术,如共享电子药物计划(电子药物计划)和瑞士电子病历,正在瑞士各地越来越多地推广。它们可以支持初级保健医生和老年人优化药物使用并减少药物相关危害。了解用户期望对于在初级保健环境中实施药物管理信息技术至关重要。

目的

本研究旨在探讨初级保健医生和老年人对药物管理信息技术的体验和态度,并确定其使用的障碍和促进因素。

方法

我们采用了一种收敛性混合方法设计,于2024年1月至8月对瑞士初级保健环境中的初级保健医生和老年人进行了基于互联网的问卷调查和半结构化访谈。参与者包括每天使用≥2种处方药的≥60岁老年人,以及在瑞士执业的初级保健医生。定量问卷数据使用描述性统计进行分析,以描述当前对药物管理信息技术的使用情况和态度。定性数据使用主题分析进行分析。

结果

共有252名老年人(n = 126,50.0%为女性;平均年龄73岁,标准差7岁)和46名初级保健医生(n = 15,32.6%为女性;平均年龄54岁,标准差11岁)完成了问卷。值得注意的是,7/252(2.8%)的老年人和21/46(45.7%)的医生报告使用了共享电子药物计划。大多数老年人报告未使用瑞士电子病历(240/252,95.2%),但表示愿意在未来采用它来管理(164/240,68.3%)或共享(179/240,74.6%)他们的健康信息。大多数医生愿意使用数字工具进行药物优化(35/46,76.1%)或使用一个平台与患者及其他医疗服务提供者协调药物优化(29/46,63.0%)。对19名老年人(12/19,63.2%为女性;平均年龄77岁,标准差9岁)和16名医生(5/16,31.3%为女性)进行了访谈。定性数据有助于解释定量研究结果。老年人很少使用药物管理信息技术,而医生主要使用集成到其执业信息系统中的基本工具(如相互作用检查器)。两组的障碍和促进因素包括有关这些新技术的信息可用性、可及性、感知到的需求和益处、易用性和可及性、数据保护以及所需的时间和精力。

结论

尽管老年人和初级保健医生认识到药物管理信息技术的优势,但目前的使用仍然有限。改善所有利益相关者的可及性、易用性和培训可能有助于更广泛地采用并提高跨专业初级保健环境中的药物安全性。

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