1. A Qualitative Review of Prescribers’ Opinions of An Electronic Prescribing Software Tool
Laura Bradburn, Post Graduate Student in Advanced Pharmacy Practice, University of Strathclyde
Background
Information technology is playing an increasingly important role in aiding prescribers’ safe and cost effective prescribing. In some healthboards in NHS Scotland, an electronic prescirbing tool provides pop-ups at the point of prescribing, suggesting formulations that are cost-effective and in line with local guidance.
Objective
To explore and identify prescirbers opinions on the prescribing support tool, with a focus on identifying the main reasons why they choose to reject the interventions suggested.
Method
A qualitative study was performed using a focus group structure to collect data. 10 prescribers, selected using convenience sampling, participated in a 25-minute focus group that was conducted using a semi-structured interview format. The conversation was audio recorded, transcribed using intelligent verbatim and analysed using inductive thematic analysis to identify themes.
“Some of our doctors felt time constraints were important. You know, if you’re running behind schedule, you don’t necessarily want to spend another couple of minutes deciding what an alternative treatment would be.”
“I think if the purpose of it is to make appropriate switches, all the other stuff they’re putting in it is mitigating against that”
“I think the most useful thing is when there’s a big difference between capsule and tablet form and we just don’t know.”
Results
Factors affecting prescriber engagement with prescribing support tool
Participants felt the system offered too much information, leading to repetition and pop up fatigue.
Also affected their workflow, adding delay to a role already time constrained
Reasons for rejections
Information wasn’t always felt to be clinically relevant
Information on the system wasn’t always felt to be up-to-date or tie in well with local guidance.
Positives
Participants said they found cost-related interventions to be very helpful.
CONCLUSIONS
Participants overall perception of the prescribing support tool was negative.
It’s clear that to encourage prescriber engagement, a system with more relevant clinical information, less repetition and less effect on prescriber workflow is required.
Improvements in the prescribing support tool are necessary for it to fulfill it’s potential role in safe and cost-effective prescribing.
ACKNOWLEDGEMENTS
Professor Alexander Mullen and staff at SIPBS, University of Strathclyde. Moira Kinnear, Hazel Brown and all educational support staff in NHS Lothian. Thanks especially to participating prescribers for providing rich data for analysis.