HIOPP-6 – a pilot study on the evaluation of an electronic tool to assess and reduce the complexity of drug treatment considering patients’ views

• Published in: BMC family practice 2022-06, Vol.23 (1), p.1-164, Article 164
• Main Authors: Wurmbach, Viktoria S, Schmidt, Steffen J, Lampert, Anette, Bernard, Simone, Meid, Andreas D, Frick, Eduard, Metzner, Michael, Wilm, Stefan, Mortsiefer, Achim, Bücker, Bettina, Altiner, Attila, Sparenberg, Lisa, Szecsenyi, Joachim, Peters-Klimm, Frank, Kaufmann-Kolle, Petra, Thürmann, Petra A, Seidling, Hanna M, Haefeli, Walter E
• Format: Article
• Language: English
• Subjects: Automation; Clinical decision making; Complexity factor; Drug administration; Drug therapy; Drug treatment; Family medicine; General practice; Medical personnel; Methods; Optimization; Patient compliance; Patient outcomes; Patient-centered care; Patients; Practice; Shared decision making
• ISSN: 2731-4553; 2731-4553; 1471-2296
• DOI: 10.1186/s12875-022-01757-0

Background A complex drug treatment might pose a barrier to safe and reliable drug administration for patients. Therefore, a novel tool automatically analyzes structured medication data for factors possibly contributing to complexity and subsequently personalizes the results by evaluating the relevance of each identified factor for the patient by means of key questions. Hence, tailor-made optimization measures can be proposed. Methods In this controlled, prospective, exploratory trial the tool was evaluated with nine general practitioners (GP) in three study groups: In the two intervention groups the tool was applied in a version with (G.sub.I_with) and a version without (G.sub.I_without) integrated key questions for the personalization of the analysis, while the control group (G.sub.C) did not use any tools (routine care). Four to eight weeks after application of the tool, the benefits of the optimization measures to reduce or mitigate complexity of drug treatment were evaluated from the patient perspective. Results A total of 126 patients regularly using more than five drugs could be included for analysis. GP suggested 117 optimization measures in G.sub.I_with, 83 in G.sub.I_without, and 2 in G.sub.C. Patients in G.sub.I_with were more likely to rate an optimization measure as helpful than patients in G.sub.I_without (IRR: 3.5; 95% CI: 1.2--10.3). Thereby, the number of optimization measures recommended by the GP had no significant influence (P = 0.167). Conclusions The study suggests that an automated analysis considering patient perspectives results in more helpful optimization measures than an automated analysis alone - a result which should be further assessed in confirmatory studies. Trial registration The trial was registered retrospectively at the German Clinical Trials register under DRKS-ID DRKS00025257 (17/05/2021). Keywords: Drug treatment, Complexity factor, General practice, Patient-centered care, Shared decision making