| 1. |
- Böttiger, Ylva, et al.
(författare)
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Development and pilot testing of PHARAO-a decision support system for pharmacological risk assessment in the elderly
- 2018
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Ingår i: European Journal of Clinical Pharmacology. - : SPRINGER HEIDELBERG. - 0031-6970 .- 1432-1041. ; 74:3, s. 365-371
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study are to describe the development of PHARAO (Pharmacological Risk Assessment Online), a decision support system providing a risk profile for adverse events, associated with combined effects of multiple medicines, and to present data from a pilot study, testing the use, functionality, and acceptance of the PHARAO system in a clinical setting. About 1400 substances were scored in relation to their risk to cause any of nine common and/or serious adverse effects. Algorithms for each adverse effect score were developed to create individual risk profiles from the patients list of medication. The system was tested and integrated to the electronic medical record, during a 4-month period in two geriatric wards and three primary healthcare centers, and a questionnaire was answered by the users before and after the test period. A total of 732 substances were tagged with one or more of the nine risks, most commonly with the risk of sedation or seizures. During the pilot, the system was used 933 times in 871 patients. The most common signals generated by PHARAO in these patients were related to the risks of constipation, sedation, and bleeding. A majority of responders considered PHARAO easy to use and that it gives useful support in performing medication reviews. The PHARAO decision support system, designed as a complement to a database on drug-drug interactions used nationally, worked as intended and was appreciated by the users during a 4-month test period. Integration aspects need to be improved to minimize unnecessary signaling.
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| 2. |
- Jalali, Amin, et al.
(författare)
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dfgcompare : a library to support process variant analysis through Markov models
- 2021
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Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Data-driven process analysis is an important area that relies on software support. Process variant analysis is a sort of analysis technique in which analysts compare executed process variants, a.k.a. process cohorts. This comparison can help to identify insights for improving processes. There are a few software supports to enable process cohort comparison based on the frequencies of process activities and performance metrics. These metrics are effective in cohort analysis, but they cannot support cohort comparison based on the probability of transitions among states, which is an important enabler for cohort analysis in healthcare.Results: This paper defines an approach to compare process cohorts using Markov models. The approach is formalized, and it is implemented as an open-source python library, named dfgcompare. This library can be used by other researchers to compare process cohorts. The implementation is also used to compare caregivers' behavior when prescribing drugs in the Stockholm Region. The result shows that the approach enables the comparison of process cohorts in practice.Conclusions: We conclude that dfgcompare supports identifying differences among process cohorts.
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| 3. |
- Jalali, Amin, et al.
(författare)
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Evaluating a Clinical Decision Support System for Drug-Drug Interactions
- 2019
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Ingår i: MEDINFO 2019. - : IOS Press. - 9781643680026 - 9781643680033 ; , s. 1500-1501
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Konferensbidrag (refereegranskat)abstract
- Janusmed is a clinical decision support system, developed by the Stockholm County Council that supports physicians in identifying drug-drug interactions. To determine how Janusmed is used in and affects the clinical practice, an evaluation study is currently being carried out that analyzes multiple data sources through descriptive statistics. The study focuses on how Janusmed affects the behavior of the physicians, in particular, to what extent physicians reconsider their prescription decisions based on warnings from Janusmed.
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| 4. |
- Justad, Hanna, et al.
(författare)
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Patients’ Use and Perceptions of a Drug-Drug Interaction Database : A Survey of Janusmed Interactions
- 2021
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Ingår i: Pharmacy. - : MDPI. - 2226-4787. ; 9:1, s. 1-13
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Tidskriftsartikel (refereegranskat)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 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.
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| 5. |
- Nörby, Ulrika, et al.
(författare)
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Midwives' perception of using a knowledge base on fetal impact of drugs
- 2019
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Ingår i: MEDINFO 2019 : Health and Wellbeing e-Networks for All - Proceedings of the 17th World Congress on Medical and Health Informatics - Health and Wellbeing e-Networks for All - Proceedings of the 17th World Congress on Medical and Health Informatics. - 1879-8365 .- 0926-9630. - 9781643680026 ; 264, s. 1743-1744
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Konferensbidrag (refereegranskat)abstract
- A non-commercial knowledge base providing assessments of fetal risks of medicinal drugs is a useful tool in the everyday work of midwives. The information is freely available on the internet, and according to a questionnaire study, nearly 95% of the midwives are familiar with the database, 30% use the information weekly, and 80% express that it affects their medical decisions. A vast majority of the midwives also state that it is time-saving.
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| 6. |
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| 7. |
- Nörby, Ulrika, et al.
(författare)
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Pregnant women's view on the Swedish internet resource Drugs and Birth Defects intended for health care professionals.
- 2015
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 94:9, s. 960-968
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Tidskriftsartikel (refereegranskat)abstract
- Pregnant women often have questions concerning fetal effects of drugs but reliable information intended for them is limited. This study investigated how pregnant women perceive and value the scientific resource Drugs and Birth Defects (www.janusinfo.se/fosterpaverkan) and compared their opinions to those of health care professionals.
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| 8. |
- Shemeikka, Tero, et al.
(författare)
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A health record integrated clinical decision support system to support prescriptions of pharmaceutical drugs in patients with reduced renal function : Design, development and proof of concept
- 2015
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Ingår i: International Journal of Medical Informatics. - : Elsevier BV. - 1386-5056 .- 1872-8243. ; 84:6, s. 387-395
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To develop and verify proof of concept for a clinical decision support system (CDSS) to support prescriptions of pharmaceutical drugs in patients with reduced renal function, integrated in an electronic health record system (EHR) used in both hospitals and primary care. Methods: A pilot study in one geriatric clinic, one internal medicine admission ward and two outpatient healthcare centers was evaluated with a questionnaire focusing on the usefulness of the CDSS. The usage of the system was followed in a log. Results: The CDSS is considered to increase the attention on patients with impaired renal function, provides a better understanding of dosing and is time saving. The calculated glomerular filtration rate (eGFR) and the dosing recommendation classification were perceived useful while the recommendation texts and background had been used to a lesser extent. Discussion: Few previous systems are used in primary care and cover this number of drugs. The global assessment of the CDSS scored high but some elements were used to a limited extent possibly due to accessibility or that texts were considered difficult to absorb. Choosing a formula for the calculation of eGFR in a CDSS may be problematic. Conclusions: A real-time CDSS to support kidney-related drug prescribing in both hospital and outpatient settings is valuable to the physicians. It has the potential to improve quality of drug prescribing by increasing the attention on patients with renal insufficiency and the knowledge of their drug dosing.
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| 9. |
- Wass, Sofie, et al.
(författare)
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Exploring the effects of eHealth service innovation
- 2015
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Ingår i: Health Systems. - : PALGRAVE MACMILLAN LTD. - 2047-6965 .- 2047-6973. ; 4:3, s. 212-223
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Tidskriftsartikel (refereegranskat)abstract
- To analyse the impact of implementation and use of eHealth services is fraught with difficulty, and there is often a gap between expected and identified outcomes. In this paper, we identify innovation effects of an eHealth service by applying a framework that focusses on the expected coherent impacts of implementing an IT innovation and contributes to the body of knowledge on tracking innovation effects of services in eHealth. A case study examines four different care units in a government-funded health-care setting. The results show that the effects in the first two contexts of the framework, the micro level and intra-/interorganisational level, could be clearly identified with regard to the physicians and the organisation. However, effects were lacking in the virtual context when looking beyond the involvement of the stakeholders in the eHealth service. The connections between effects for societal groups and larger societal systems simply could not be made in a satisfactory manner.
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