Understanding engagement and potential impact of an electronic drug repository: A mixed-methods study. (Preprint)

Abstract

Centralized drug repositories can reduce adverse events and inappropriate prescribing by enabling access to dispensed medication data at the point-of-care, but how they achieve this goal is largely unknown.

To understand 1) the perceived clinical value; 2) the barriers and enablers to adoption; and 3) for which clinician groups a provincial, centralized drug repository may provide the most benefit.

A mixed-method approach, including an online survey and semi-structured interviews, was employed. Participants were clinicians (e.g., nurses, physicians, and pharmacists) in Ontario who were eligible to use the Digital Health Drug Repository (DHDR), irrespective of actual use. Survey data were ranked on a 7-point adjectival scale and analyzed using descriptive statistics and interviews were analyzed using qualitative description.

: Of 167 survey respondents, only 24% (n=40) were actively using the DHDR. Perceptions of the utility of the DHDR were neutral (mean scores ranged from 4.11-4.76). Of the 76% who were not using the DHDR, 98% rated access to medication information (e.g., dose, strength, frequency) as important. Reasons for not using the DHDR included the cumbersome access process and the perception that available data was incomplete or inaccurate. A total of 33 interviews were completed, of which 26 were active DHDR users. The DHDR was a satisfactory source of secondary information, but the absence of medication instructions and prescribed medications (that were not dispensed) limited its ability to provide a comprehensive profile in order to meaningfully support clinical decision-making.

Digital drug repositories must adjust to align with clinician needs to provide value. Ensuring (1) integration with point-of-care systems; (2) comprehensive clinical data; and (3) streamlined onboarding processes would optimize clinically meaningful use. The electronic provision of accessible drug information to providers across healthcare settings has the potential to improve efficiency and reduce medication errors.

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