Usabilidade da APIMedOlder: Uma Aplicação Web para a Gestão de Medicamentos Potencialmente Inapropriados em Idosos
DOI:
https://doi.org/10.20344/amp.21537Palavras-chave:
Erros de Medicação/prevenção e controlo, Idoso, Internet, Lista de Medicamentos Potencialmente Inapropriados, Prescrição Inapropriada/ prevenção e controlo, Sistemas de Apoio à Decisão ClínicaResumo
Introdução: Tendo em conta o aumento da proporção da população idosa em todo o mundo, surge também a demanda por recursos dos sistemas de saúde. Estas ferramentas otimizam a decisão clínica, evitando iatrogenia, contribuindo assim para uma melhor qualidade de vida dos idosos. Em resposta, criámos uma aplicação web online, APIMedOlder, para proporcionar acesso por parte dos profissionais de saúde aos critérios de identificação de medicamentos potencialmente inapropriados através de uma ferramenta útil com um perfil simplificado, permitindo a sua aplicabilidade na prática clínica. Este estudo tem como objetivo a avaliação da usabilidade da aplicação web online APIMedOlder por parte dos profissionais de saúde.
Métodos: Foi distribuído um questionário, baseado na Escala de Usabilidade do Sistema, a 15 profissionais de saúde (cinco farmacêuticos, quatro médicos, três técnicos de farmácia e três enfermeiros), de forma a explorar completamente a aplicação web.
Resultados: No geral, a avaliação dos profissionais de saúde sobre a usabilidade da aplicação web online APIMedOlder foi classificada como “Best imaginable” (pontuação média de 87,17 pontos), com pontuações individuais a variar entre 75 e 100 pontos. Foi alcançada uma consistência interna de α = 0,881 (IC 95%: 0,766 - 0,953). Os itens específicos do questionário que contribuíram para esta pontuação incluíram facilidade de uso, eficiência de aprendizagem e integração de funções.
Conclusão: A avaliação geral da ferramenta desenvolvida foi positiva, tendo sido reconhecida como fácil de utilizar e com funções bem integradas.
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Referências
United Nations Department of Economic and Social Affairs. World population ageing 2020: Highlights. New York: UN; 2021.
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380:37-43.
Hedna K, Hakkarainen KM, Gyllensten H, Jönsson AK, Petzold M, Hägg S. Potentially inappropriate prescribing and adverse drug reactions in the elderly: a population-based study. Eur J Clin Pharmacol. 2015;71:1525-33.
Waring RH, Harris RM, Mitchell SC. Drug metabolism in the elderly: a multifactorial problem? Maturitas. 2017;100:27-32.
Renom-Guiteras A, Meyer G, Thürmann PA. The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol. 2015;71:861-75.
Fick DM, Semla TP, Steinman M, Beizer J, Brandt N, Dombrowski R, et al. American Geriatrics Society 2019 Updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67:674-94.
Fu AZ, Liu GG, Christensen DB. Inappropriate medication use and health outcomes in the elderly. J Am Geriatr Soc. 2004;52:1934-9.
Rechel B, Doyle Y, Grundy E, Mckee M. How can health systems respond to population ageing? Copenhagen: World Health Organisation, Regional Office for Europe; 2009.
Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, et al. Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Int Med. 2007;22:391-5.
Schofield DJ, Earnest A. Demographic change and the future demand for public hospital care in Australia, 2005 to 2050. Aust Health Rev. 2006;30:507-15.
National Research Council Committee on Engaging the Computer Science Research Community in Health Care Informatics. Computational technology for effective health care: immediate steps and strategic directions. Stead WW, Lin HS, editors. Washington: National Academies Press; 2009.
Smith MY, Frise S, Feron J, Marshall R. Improving the safety of medicines via digital technology: an assessment of the scope and quality of risk minimization websites in the United States and United Kingdom. Drug Saf. 2022;45:259-74.
Rudel D, Fisk M, Roze R. Definitions of terms in telehealth. Infor Med Slov. 2011;16:28-46.
Campanella P, Lovato E, Marone C, Fallacara L, Mancuso A, Ricciardi W, et al. The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. Eur J Public Health. 2016;26:60-4.
San Filippo S, Yuan M, Gu E, Siddiqui S, Patel S. Utilization of drug decision support strategies including drug characteristics to reduce the risk of iatrogenesis in advanced age. Curr Pharmacol Rep. 2023;9:1-11.
Tudor Car L, Soong A, Kyaw BM, Chua KL, Low-Beer N, Majeed A. Health professions digital education on clinical practice guidelines: a systematic review by Digital Health Education collaboration. BMC Med. 2019;17:139.
Perpétuo C, Plácido AI, Rodrigues D, Aperta J, Piñeiro-Lamas M, Figueiras A, et al. Prescription of potentially inappropriate medication in older inpatients of an internal medicine ward: concordance and overlap among the EU(7)-PIM list and beers and STOPP criteria. Front Pharmacol. 2021;12:676020.
Plácido AI, Aguiar A, Piñeiro-Lamas M, Varallo F, Figueiras A, Herdeiro MT, et al. Assessment of potentially inappropriate medications using the EU (7)-PIM List, in a sample of Portuguese older adults’ residents in nursing homes. Risk Manag Healthc Policy. 2022;15:1343-52.
Rodrigues DA, Plácido AI, Tavares AB, Azevedo D, Mateos-Campos R, Figueiras A, et al. Potentially inappropriate medication prescribing in older adults according to EU(7)-potentially inappropriate medication list: a nationwide study in Portugal. Curr Ther Res. 2022;97:100681.
Gomes D, Herdeiro MT, Ribeiro-Vaz I, Ferreira PL, Roque F. Adverse drug reactions and potentially inappropriate medication in older patients: analysis of the Portuguese pharmacovigilance database. J Clin Med. 2022;11:2229.
Peixoto S, Almeida A, Caramelo A, Mendes L. Aplicação dos critérios de Beers de 2015 operacionalizados para Portugal em pessoas idosas institucionalizadas: um estudo transversal. Acta Med Port. 2021;34:741-8.
Rodrigues DA, Plácido AI, Mateos-Campos R, Figueiras A, Herdeiro MT, Roque F. Effectiveness of interventions to reduce potentially inappropriate medication in older patients: a systematic review. Front Pharmacol. 2022;12:777655.
Roque F, Herdeiro MT, Figueiras A, Plácido AI, Rodrigues DA. Medicamento potencialmente inapropriado. APIMedOlder. 2022. [cited 2022 Nov 03]. Available from: https://apimedolder.com.
Esmeria GJ, Seva RR. Web usability: a literature review. Manilla: De La Salle University Research Congress; 2017.
International Organization for Standardization. ISO 9241-11; Part 11: G. Geneva: IOS; 1998.
Rodrigues DA, Herdeiro MT, Thurmann PA, Figueiras A, Coutinho P, Roque F. Operationalisation for Portugal of the EU(7)-PIM list for identification of potentially inappropriate medicines in older adults. Acta Med Port. 2020;33:194-200.
Macefield R. How to specify the participant group size for usability studies: a practitioner’s guide. J Usability Stud. 2009;5:34-45.
Faulkner L. Beyond the five-user assumption: benefits of increased sample sizes in usability testing. Beh Res Meth Instr Comp. 2003;35:379-83.
Brooke J. SUS - A quick and dirty usability scale Usability and context. In: Usability evaluation in industry. London: Routledge; 1996. p.4-7.
Sauro J. Measuring usability with the system usability scale (SUS). 2011. [cited 2022 May 27]. Available from: https://measuringu.com/sus/.
Martins AI, Rosa AF, Queirós A, Silva A, Rocha NP. European Portuguese validation of the system usability scale (SUS). Procedia Comput Sci. 2015;67:293-300.
Bangor A, Kortum PT, Miller JT. An empirical evaluation of the system usability scale. Int J Hum Comput Interact. 2008;24:574-94.
Moura J, Estrela M, Almeida AM, Ferraz I. A usability study of pharmacists’ perceptions toward an online course for respiratory infections and antibiotic use. Procedia Comput Sci. 2021;181:269-76.
Estrela M, Magalhães Silva T, Pisco Almeida AM, Regueira C, ZapataCachafeiro M, Figueiras A, et al. A roadmap for the development and evaluation of the eHealthResp online course. Digit Health. 2022;8:1-7.
Trafton J, Martins S, Michel M, Lewis E, Wang D, Combs A, et al. Evaluation of the acceptability and usability of a decision support system to encourage safe and effective use of opioid therapy for chronic, noncancer pain by primary care providers. Pain Med. 2010;11:575-85.
van der Nat DJ, Huiskes VJ, Taks M, Pouls BP, van den Bemt BJ, van Onzenoort HA. Usability and perceived usefulness of patientcentered medication reconciliation using a personalized health record: a multicenter cross-sectional study. BMC Health Serv Res. 2022;22:776.
Sigle S, Barriga P, Fernández FJ, Juhra C, Härtel S, Fegeler C. Evaluating online consumer medication information systems: comparative online usability study. JMIR Mhealth Uhealth. 2020;8:e16648.
Richter Lagha R, Burningham Z, Sauer BC, Leng J, Peters C, Huynh T, et al. Usability testing a potentially inappropriate medication dashboard: a core component of the dashboard development process. Appl Clin Inform. 2020;11:528-34.
Klug B. An overview of the system usability scale in library website and system usability testing. Weave: Journal of Library User Experience. 2017;1.
Kortum P, Oswald FL. The impact of personality on the subjective assessment of usability. Int J Hum Comput Interact. 2018;34:177-86.
Kortum P, Acemyan CZ. The impact of geographic location on the subjective assessment of system usability. Int J Hum Comput Interact. 2019;35:123-30.
Lewis JR. The system usability scale: past, present, and future. Int J Hum Comput Interact. 2018;34:577-90.
Ilker M, Msc B, Karahoca D. Re-assessing the usability metric for user experience (UMUX) Scale. J Usability Stud. 2016;11:89-109.
Borsci S, Federici S, Bacci S, Gnaldi M, Bartolucci F. Assessing user satisfaction in the era of user experience: comparison of the SUS, UMUX, and UMUX-LITE as a function of product experience. Int J Hum Comput Interact. 2015;31:484-95.
Bangor A, Kortum P, Miller J. Determining what individual SUS scores mean: adding an adjective rating scale. J Usability Stud. 2009;4:114-23.
Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003;80:99-103.
Tavakol M, Dennick R. Making sense of cronbach’s alpha. Int J Med Educ. 2011;2:53-5.
Masters K. For what purpose and reasons do doctors use the Internet: a systematic review. Int J Med Inform. 2008;77:4-16.
Del Fiol G, Workman TE, Gorman PN. Clinical questions raised by clinicians at the point of care a systematic review. JAMA Intern Med. 2014;174:710-8.
Eysenbach G. Credibility of health information and digital media: new perspectives and implications for youth. In: Metzger MJ, Flanagin AJ, editors. Digital media, youth, and credibility. The John D. and Catherine T. MacArthur Foundation Series on Digital Media and Learning. Cambridge: The MIT Press; 2008. p.123-54.
Rayan RA, Tsagkaris C, Iryna RB. The internet of things for healthcare: applications, selected cases and challenges. In: Marques G, Bhoi AK, Albuquerque VH, editors. IoT in healthcare and ambient assisted living. Studies in Computational Intelligence, vol 933. Singapore: Springer; 2021.
Gonçalves-Bradley DC, J Maria AR, Ricci-Cabello I, Villanueva G, Fønhus MS, Glenton C, et al. Mobile technologies to support healthcare provider to healthcare provider communication and management of care. Cochrane Database Syst Rev. 2020;8:CD012927.
Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144:742-52.
DataReportal. Digital 2022: Portugal. Internet use in Portugal in 2022. 2022. [cited 2022 Oct 17]. Available from: https://datareportal.com/reports/digital-2022-portugal.
Braun R, Catalani C, Wimbush J, Israelski D. Community health workers and mobile technology: a systematic review of the literature. PLoS One. 2013;8:e65772.
Alroobaea R, Mayhew PJ. How many participants are really enough for usability studies? Proceedings of 2014 Science and Information Conference. 2014:48-56.
Rodrigues DA, Roque M, Mateos-Campos R, Figueiras A, Herdeiro MT, Roque F. Barriers and facilitators of health professionals in adopting digital health-related tools for medication appropriateness: a systematic review. Digit Health. 2024;10:20552076231225133.
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