The role of Design Science Research Methodology in developing pharmacy eHealth services

The Development and Evaluation of an Animated Video for Pre- and Postoperative Instructions for Patients with Osteoarthritis-A Design Science Research Approach

Osteoarthritis (OA) is a condition in the hip or knee joints that develops during a long period of time and sometimes needs hip or knee joint replacement surgery when pain gets too intense for the patient. This paper describes how an animated video for pre- and postoperative instructions for patients with osteoarthritis was designed. The design science research (DSR) approach was followed by creating a web-based animated video. The web-based animated video is used to support surgical departments with education for patients suffering from OA. In the web-based animated video, information about OA surgical treatment and its pre- and post-arrangements was included. The relevance, the rigor, and the design cycles were focused on, with some iterations of and improvements in the animations. Even after implementation, there was a feedback-loop with comments from the surgeons and their patients. Moreover, as more departments will use the web-based animated video, they want to make their special mark on it, so that further changes will be made. This paper presents the design and successful implementation of an animated video for pre- and postoperative instructions for patients with osteoarthritis, tightly linked to the patient journey and the workflow of healthcare professionals. The animated video serves not only as a tool to improve care but also as a basis for further scientific research studies.

Exploring experiences of pharmacists and pharmacy students using mHealth apps: A qualitative study of user experience

PURPOSE

Pharmacists can enhance mHealth delivery by promoting the awareness and use of health apps, while pharmacy students and early career pharmacists allow broader perspective for further development. This study aimed to explore the experiences and attitudes of pharmacy students and pharmacists, on the use, advantages and possible improvement of available mHealth platforms in Serbia.

METHODS

One-on-one interviews were conducted online in two phases, during March and April 2020 (n = 40) and during March 2021 (n = 20), using a published, validated interview guide which was adapted for this study. Interviews were transcribed ad verbatim, coded and thematically analysed.

RESULTS

Although participants recognized room for optimization, most apps had satisfactory user experience. Participants used health apps as a source of updated information and tools in education and work, but also for self-development. During working hours, participants mostly used medication-related apps, however, it was shown that they use different health apps in order to provide the best possible care to patients.

CONCLUSIONS

Greater insight into usage, expectations, benefits and challenges of mHealth in pharmacy was obtained and can lead into better informed design of health apps to encourage students and pharmacists, both as professionals and individuals, on the path of their continuous improvement.

Intelligent Clinical Decision Support System for Managing COPD Patients

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Health remote monitoring systems (HRMSs) play a crucial role in managing COPD patients by identifying anomalies in their biometric signs and alerting healthcare professionals. By analyzing the relationships between biometric signs and environmental factors, it is possible to develop artificial intelligence models that are capable of inferring patients' future health deterioration risks. In this research work, we review recent works in this area and develop an intelligent clinical decision support system (CIDSS) that is capable of providing early information concerning patient health evolution and risk analysis in order to support the treatment of COPD patients. The present work's CIDSS is composed of two main modules: the vital signs prediction module and the early warning score calculation module, which generate the patient health information and deterioration risks, respectively. Additionally, the CIDSS generates alerts whenever a biometric sign measurement falls outside the allowed range for a patient or in case a basal value changes significantly. Finally, the system was implemented and assessed in a real case and validated in clinical terms through an evaluation survey answered by healthcare professionals involved in the project. In conclusion, the CIDSS proves to be a useful and valuable tool for medical and healthcare professionals, enabling proactive intervention and facilitating adjustments to the medical treatment of patients.

Design and evaluation of a new nurse-led case management intervention for bariatric surgery patients

This paper provides a new management about the treatment of obesity, that have a growing incidence worldwide. A management centered on the patients' needs during the bariatric surgery is necessary. In this context, patient monitoring and follow-up by a case manager, who guides the provision of specialized care focused on patient's adaptation to the new reality, can prove to be essential to achieve better outcomes. This study, guided by the Design Science Research Methodology (DSRM), will have as main objective to design a new intervention (Case-managing program) aimed at patients undergoing bariatric surgery. As secondary objectives, we intend to analyze the influence of the new intervention in the perioperative period and impact on several clinical and humanistic endpoints. In the evaluation phase, an experimental, controlled, and randomized study (RCT) will be developed, with an intervention group (IG) and a control group (CG). The CG will receive the usual care and the IG, will receive the intervention for an expected period of one year. This project aims to be the first study to investigate the effect of a long-term specialized case-management intervention (face-to-face and e-health) in patients who are candidates for bariatric surgery during all the perioperative periods. This method presents: • The results will be reported the patients related outcomes measures for bariatric surgery • The results are expected to provide an overview of the most effective case management interventions for long-term better results on bariatric surgery • Allowing researchers to design and propose a new case management for bariatric surgery.

Health information communication technology evaluation frameworks for pharmacist prescribing: A systematic scoping review

BACKGROUND

Information communication technology (ICT) is instrumental in pharmacists' current practice and emerging roles. One such role is prescribing, which requires the use of clinical guidelines and documentation of decision-making, commonly via ICT. Development and refinement of ICT should be guided by evaluation frameworks that describe or measure features of ICT and its implementation. In the context of pharmacist prescribing, these evaluation frameworks should be specific to health stakeholders and the pharmacy setting.

OBJECTIVES

To identify ICT evaluation frameworks from health-related literature and review frameworks relevant to the development, implementation, and evaluation of pharmacist prescribing.

METHODS

A database search of CINAHL, Cochrane Library, EMBASE, Medline (Ovid), ProQuest, Scopus, Web of Science and grey literature was conducted, using combinations of keywords relating to 'ICT', 'utilization', 'usability', and 'evaluation framework'. Abstracts and titles were screened according to inclusion criteria. Identified evaluation frameworks were critiqued for relevance to pharmacy practice.

RESULTS

Twenty-two articles were identified, describing the development or application of 20 evaluation frameworks. None of the frameworks was developed specifically for pharmacy practice. The Technology Acceptance Model (TAM), describing use behavior, behavior intention, perceived usefulness, and perceived ease of use, was the most widely utilized framework. The Information System Success (ISS) and Human-Organization and Technology Fit (HOT-fit) are notable evaluation frameworks that address user and organizational influences in health ICT utility, and factors of both can address the limitation of TAM.

CONCLUSIONS

The findings call for development of an agile evaluation framework for the system under review; however, this can prove difficult due to the heterogenicity and complexity of the healthcare system, particularly contemporary pharmacy practice. While the TAM appears useful to evaluate user attitudes and intentions towards ICT, its relevance to ICT in contemporary community pharmacy practice requires exploration.

Reimbursed medication adherence enhancing interventions in 12 european countries: Current state of the art and future challenges

Background: Medication non-adherence jeopardises the effectiveness of chronic therapies and negatively affects financial sustainability of healthcare systems. Available medication adherence-enhancing interventions (MAEIs) are utilised infrequently, and even more rarely reimbursed. The aim of this paper was to review reimbursed MAEIs across selected European countries.

Methods: Data on reimbursed MAEIs were collected from European countries at the ENABLE Cost Action expert meeting in September 2021. The identified MAEIs were analysed and clustered according to their characteristics, direct vs. indirect relation to adherence, and the targeted adherence phase.

Results: Out of 12 contributing countries, 10 reported reimbursed MAEIs, 28 in total, of which 20 were identified as MAEIs targeting adherence directly. Reimbursed MAEIs were most often performed by either doctors (n = 6), nurses (n = 6), or pharmacists (n = 3). The most common types of MAEIs were education (n = 6), medication regimen management (n = 5), and adherence monitoring feedback (n = 4). Only seven reimbursed MAEIs were technology-mediated, whereas 11 addressed two interlinked phases of medication adherence, i.e., implementation and persistence.

Conclusion: Our review highlights the scarcity of reimbursed MAEIs across the selected European countries, and calls for their more frequent use and reimbursement.