Usability of APIMedOlder: A Web Application to Manage Potentially Inappropriate Medication in Older Adults

Authors

  • Daniela A. Rodrigues Biotechnology Research, Innovation and Design for Health Products (BRIDGES) - Research Laboratory on Epidemiology and Population Health. Instituto Politécnico da Guarda. Guarda; Health Sciences Research Centre (CICS). Universidade da Beira Interior. Covilhã; Universidad de Salamanca. Salamanca. Spain.
  • Ana I. Plácido Biotechnology Research, Innovation and Design for Health Products (BRIDGES) - Research Laboratory on Epidemiology and Population Health. Instituto Politécnico da Guarda. Guarda.
  • Ramona Mateos-Campos Area of Preventive Medicine and Public Health. Department of Biomedical and Diagnostic Sciences. Universidad de Salamanca. Salamanca. Spain.
  • Adolfo Figueiras Department of Preventive Medicine and Public Health. Universidade de Santiago de Compostela. Santiago de Compostela. Spain; Health Research Institute of Santiago de Compostela (IDIS). Santiago de Compostela. Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP). Madrid. Spain.
  • Maria Teresa Herdeiro Department of Medical Sciences. Institute of Biomedicine (iBiMED). Universidade de Aveiro. Aveiro.
  • Fátima Roque Biotechnology Research, Innovation and Design for Health Products (BRIDGES) - Research Laboratory on Epidemiology and Population Health. Instituto Politécnico da Guarda. Guarda; Health Sciences Research Centre (CICS). Universidade da Beira Interior. Covilhã.

DOI:

https://doi.org/10.20344/amp.21537

Keywords:

Aged, Decision Support Systems, Clinical, Inappropriate Prescribing/prevention & control, Internet, Medication Errors/prevention & control, Potentially Inappropriate Medication List

Abstract

Introduction: Considering the increase in the proportion of the older population worldwide, the demand for health system resources also arises. These tools optimize clinical decision-making, thus avoiding iatrogenesis and thus contributing to a better quality of life for the older population. In response, we created an online web application, the APIMedOlder, that provides access to healthcare professionals to allow healthcare professionals to access potentially inappropriate medication identification criteria through a useful tool with a simplified profile, allowing its applicability in clinical practice. This study aims to assess the usability of the APIMedOlder online web application by healthcare professionals.
Methods: A questionnaire, based on the System Usability Scale, was distributed among 15 healthcare professionals (five pharmacists, four physicians, three pharmacy technicians, and three nurses), to fully explore the website.
Results: Overall, healthcare professionals’ evaluation of the usability of the APIMedOlder online web application was rated as “Best imaginable” (mean score of 87.17 points), with individual scores ranging from 75 to 100 points. Internal consistency of α = 0.881 (CI 95%: 0.766 - 0.953) was achieved. Specific questionnaire items contributing to this high score included ease of use, learning efficiency, and integration of functions.
Conclusion: The overall evaluation of the developed tool was positive, with this online application being recognized as being easy to use and having well-integrated functions.

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References

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. DOI: https://doi.org/10.1016/S0140-6736(12)60240-2

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. DOI: https://doi.org/10.1007/s00228-015-1950-8

Waring RH, Harris RM, Mitchell SC. Drug metabolism in the elderly: a multifactorial problem? Maturitas. 2017;100:27-32. DOI: https://doi.org/10.1016/j.maturitas.2017.03.004

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. DOI: https://doi.org/10.1007/s00228-015-1860-9

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. DOI: https://doi.org/10.1111/jgs.15767

Fu AZ, Liu GG, Christensen DB. Inappropriate medication use and health outcomes in the elderly. J Am Geriatr Soc. 2004;52:1934-9. DOI: https://doi.org/10.1111/j.1532-5415.2004.52522.x

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. DOI: https://doi.org/10.1007/s11606-007-0322-1

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. DOI: https://doi.org/10.1071/AH060507

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. DOI: https://doi.org/10.1007/s40264-022-01165-4

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. DOI: https://doi.org/10.1093/eurpub/ckv122

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. DOI: https://doi.org/10.1007/s40495-022-00310-y

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. DOI: https://doi.org/10.1186/s12916-019-1370-1

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. DOI: https://doi.org/10.3389/fphar.2021.676020

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. DOI: https://doi.org/10.2147/RMHP.S346300

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. DOI: https://doi.org/10.1016/j.curtheres.2022.100681

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. DOI: https://doi.org/10.3390/jcm11082229

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. DOI: https://doi.org/10.20344/amp.13030

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. DOI: https://doi.org/10.3389/fphar.2021.777655

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. DOI: https://doi.org/10.20344/amp.13618

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. DOI: https://doi.org/10.3758/BF03195514

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. DOI: https://doi.org/10.1016/j.procs.2015.09.273

Bangor A, Kortum PT, Miller JT. An empirical evaluation of the system usability scale. Int J Hum Comput Interact. 2008;24:574-94. DOI: https://doi.org/10.1080/10447310802205776

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. DOI: https://doi.org/10.1016/j.procs.2021.01.146

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. DOI: https://doi.org/10.1177/20552076221089088

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. DOI: https://doi.org/10.1111/j.1526-4637.2010.00818.x

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. DOI: https://doi.org/10.1186/s12913-022-07967-7

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. DOI: https://doi.org/10.2196/16648

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. DOI: https://doi.org/10.1055/s-0040-1714693

Klug B. An overview of the system usability scale in library website and system usability testing. Weave: Journal of Library User Experience. 2017;1. DOI: https://doi.org/10.3998/weave.12535642.0001.602

Kortum P, Oswald FL. The impact of personality on the subjective assessment of usability. Int J Hum Comput Interact. 2018;34:177-86. DOI: https://doi.org/10.1080/10447318.2017.1336317

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. DOI: https://doi.org/10.1080/10447318.2018.1437865

Lewis JR. The system usability scale: past, present, and future. Int J Hum Comput Interact. 2018;34:577-90. DOI: https://doi.org/10.1080/10447318.2018.1455307

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. DOI: https://doi.org/10.1080/10447318.2015.1064648

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. DOI: https://doi.org/10.1207/S15327752JPA8001_18

Tavakol M, Dennick R. Making sense of cronbach’s alpha. Int J Med Educ. 2011;2:53-5. DOI: https://doi.org/10.5116/ijme.4dfb.8dfd

Masters K. For what purpose and reasons do doctors use the Internet: a systematic review. Int J Med Inform. 2008;77:4-16. DOI: https://doi.org/10.1016/j.ijmedinf.2006.10.002

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. DOI: https://doi.org/10.1001/jamainternmed.2014.368

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. DOI: https://doi.org/10.1007/978-981-15-9897-5_1

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. DOI: https://doi.org/10.1002/14651858.CD012927.pub2

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. DOI: https://doi.org/10.7326/0003-4819-144-10-200605160-00125

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. DOI: https://doi.org/10.1371/journal.pone.0065772

Alroobaea R, Mayhew PJ. How many participants are really enough for usability studies? Proceedings of 2014 Science and Information Conference. 2014:48-56. DOI: https://doi.org/10.1109/SAI.2014.6918171

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. DOI: https://doi.org/10.1177/20552076231225133

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Published

2024-09-02

How to Cite

1.
A. Rodrigues D, I. Plácido A, Mateos-Campos R, Figueiras A, Herdeiro MT, Roque F. Usability of APIMedOlder: A Web Application to Manage Potentially Inappropriate Medication in Older Adults. Acta Med Port [Internet]. 2024 Sep. 2 [cited 2024 Oct. 5];37(9):609-16. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/21537

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