Physicians' reported needs of drug information at point of care in Sweden

Authors

  • Pia Bastholm Rahmner,

    Corresponding author
    1. Centre of Medical Knowledge, Stockholm County Council, Stockholm
      Mr Pia Bastholm Rahmner PhD, Centre of Medical Knowledge, Stockholm County Council, Box 17533, SE-118 91 Stockholm, Sweden. Tel.: +46 8 737 40 79. Fax: +46 8 737 40 12. E-mail: pia.bastholm-rahmner@sll.se
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  • Birgit Eiermann,

    1. Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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  • Seher Korkmaz,

    1. Centre of Medical Knowledge, Stockholm County Council, Stockholm
    2. Karolinska Institutet Solna, Stockholm, Sweden
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  • Lars L. Gustafsson,

    1. Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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  • Magnus Gruvén,

    1. Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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  • Simon Maxwell,

    1. Clinical Pharmacology Unit, University of Edinburgh, Edinburgh
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  • Hans-Georg Eichle,

    1. European Medicines Agency, London, UK
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  • Anikó Vég

    1. Centre of Medical Knowledge, Stockholm County Council, Stockholm
    2. Health Services Research at Dept of Public Health and Caring Sciences, Uppsala University, Uppsala
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Mr Pia Bastholm Rahmner PhD, Centre of Medical Knowledge, Stockholm County Council, Box 17533, SE-118 91 Stockholm, Sweden. Tel.: +46 8 737 40 79. Fax: +46 8 737 40 12. E-mail: pia.bastholm-rahmner@sll.se

Abstract

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• The computerization of health care has increased dramatically in the last decades in most European countries, but no standardization of any of the information support systems has been established on common ground.

• The Summary of Product Characteristics (SmPC) is available all over Europe in written form and in some of the countries even electronically, but the structure and the content of the information vary.

• The physicians' needs for useful and reliable information about drugs at point of care are a question of patient safety.

WHAT THIS STUDY ADDS

• A qualitative approach, in this case focus group discussions, proved advantagous compared with questionnaires.

• Knowledge gained from physicians' experiences promoted the work of restructuring and organizing the e-SmPC database.

• Most of the required information from physicians appeared to be possible to transfer from current SmPCs to clinical decisions support systems.

AIMS

Relevant and easily accessible drug information at point-of-care is essential for physicians' decision making when prescribing. However, the information available by using Clinical Decision Support Systems (CDSSs) often does not meet physicians' requirements. The Summary of Product Characteristics (SmPC) is statutory information about drugs. However, the current structure, content and format of SmPCs make it difficult to incorporate them into CDSSs and link them to relevant patient information from the Electronic Health Records. The aim of the study was to evaluate the perceived needs for drug information among physicians in Sweden.

METHODS

We recruited three focus group discussions with 18 physicians covering different specialities. The information from the groups was combined with a questionnaire administered at the beginning of the group discussions.

RESULTS

Physicians reported their needs for knowledge databases at the point of drug prescribing. This included more consistent information about existing and new drugs. They also wished to receive automatically generated alerts for severe drug–drug interactions and adverse effects, and to have functions for calculating glomerular filtration rate to enable appropriate dose adjustments to be made for elderly patients and those with impaired renal function. Additionally, features enhancing electronic communication with colleagues and making drug information more searchable were suggested.

CONCLUSIONS

The results from the current study showed the need for knowledge databases which provide consistent information about new and existing drugs. Most of the required information from physicians appeared to be possible to transfer from current SmPCs to CDSSs. However, inconsistencies in the SmPC information have to be reduced to enhance their utility.

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