Int J Med Inform - Personal digital assistant with a barcode reader--a medical decision support system for nurses in home care.


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TRODUCTION: Inappropriate medication among elderly people increases the risk of adverse drug-drug interactions, drug-related falls and hospital admissions. In order to prevent these effects it is necessary to obtain a profile of the patients' medication. A personal digital assistant (PDA) can be used as a medical decision support system (MDSS) to obtain a profile of the patients' medication and to check for inappropriate drugs and drug combinations, and to reduce medication errors.AIM: The aim of the present study was to evaluate nurses' experiences of using a MDSS in a PDA with a barcode reader, in order to obtain profiles of the patients' medication, regarding drug-drug interactions, therapeutic duplications, and warnings for drugs unsuitable for elderly in home care.METHODS: The LIFe-reader is a MDSS in a PDA with a barcode reader. By scanning the drug packages in the patients' home, the LIFe-reader obtained profiles of the patients' medication and checked for drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. The LIFe-reader also contained, e.g. drug information and medical reference works. Nurses (n=15) used the LIFe-reader for five weeks during their nursing home care practice assignment. The nurses answered questionnaires about the content and functions of the LIFe-reader before, during and after the nursing home care practice assignment, and were interviewed in focus groups. Descriptive statistics were used and content analysis was applied for qualitative data.RESULTS: By using the LIFe-reader, the majority of the nurses found it easy to obtain profiles of the patients' medication and check for drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. Most nurses regarded the LIFe-reader to reduce drug-related risks of falling, and some thought it could reduce the drug-related admissions to hospitals. The scanning function was described as easy and time saving, although not always possible to use. The LIFe-reader was regarded as a useful and user-friendly MDSS, but more content and functions were requested.CONCLUSIONS: We found that the LIFe-reader has the potential to be a useful and user-friendly MDSS for nurses in home care when obtaining profiles of the patients' medication regarding drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly. A regular scanning of the patients' drugs in their home might support nurses and general practitioners (GPs) in reducing the inappropriate use of drugs. If the LIFe-reader should be used in a larger scale among nurses, more content and functions are necessary.

Resumo Limpo

troduct inappropri medic among elder peopl increas risk advers drugdrug interact drugrel fall hospit admiss order prevent effect necessari obtain profil patient medic person digit assist pda can use medic decis support system mdss obtain profil patient medic check inappropri drug drug combin reduc medic errorsaim aim present studi evalu nurs experi use mdss pda barcod reader order obtain profil patient medic regard drugdrug interact therapeut duplic warn drug unsuit elder home caremethod liferead mdss pda barcod reader scan drug packag patient home liferead obtain profil patient medic check drugdrug interact therapeut duplic warn drug unsuit elder peopl liferead also contain eg drug inform medic refer work nurs n use liferead five week nurs home care practic assign nurs answer questionnair content function liferead nurs home care practic assign interview focus group descript statist use content analysi appli qualit dataresult use liferead major nurs found easi obtain profil patient medic check drugdrug interact therapeut duplic warn drug unsuit elder peopl nurs regard liferead reduc drugrel risk fall thought reduc drugrel admiss hospit scan function describ easi time save although alway possibl use liferead regard use userfriend mdss content function requestedconclus found liferead potenti use userfriend mdss nurs home care obtain profil patient medic regard drugdrug interact therapeut duplic warn drug unsuit elder regular scan patient drug home might support nurs general practition gps reduc inappropri use drug liferead use larger scale among nurs content function necessari

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