ABiMed用可视化工具辅助药师发现更多用药问题，且不增加时间负担。
A randomized simulation trial evaluating ABiMed, a clinical decision support system for medication reviews and polypharmacy management
- 基于STOPP/START v2指南，用图表和花形符号呈现药物知识
- 使用ABiMed后药师发现问题数提升1.6倍，干预质量更高
- 系统易用性评分优秀，对不同年龄性别的药师效果一致
背景：药物审查是药师通过结构化访谈优化用药的临床实践，但耗时且认知负荷高。尽管已有临床指南，其应用仍繁琐。方法：我们设计了ABiMed，一个基于STOPP/START v2指南、结合表格、图表和花形符号可视化聚合药物知识的临床决策支持系统。在随机模拟试验中，39名社区药师分别对4名虚构患者进行药物审查：2例无系统支持，2例使用ABiMed。记录发现问题数量、建议干预措施、反应时间、可用性评分及反馈。将药师结果与专家制定的金标准对比。结果：使用ABiMed后，药师发现的药物相关问题多出1.6倍（p=1.1e-12），提出的干预更优（p=9.8e-9），且耗时无显著差异（p=0.56）。系统可用性量表得分为82.7，属“优秀”。药师普遍赞赏其可视化呈现与治疗方案对比功能。多因素分析显示，年龄或性别不影响系统在发现问题数量或干预质量上的增益。结论：智能可视化临床决策支持系统可有效辅助药师完成药物审查。未来需在真实临床环境中验证。
原文摘要 · Abstract (English)
Background: Medication review is a structured interview of the patient, performed by the pharmacist and aimed at optimizing drug treatments. In practice, medication review is a long and cognitively-demanding task that requires specific knowledge. Clinical practice guidelines have been proposed, but their application is tedious. Methods: We designed ABiMed, a clinical decision support system for medication reviews, based on the implementation of the STOPP/START v2 guidelines and on the visual presentation of aggregated drug knowledge using tables, graphs and flower glyphs. We evaluated ABiMed with 39 community pharmacists during a randomized simulation trial, each pharmacist performing a medication review for two fictitious patients without ABiMed, and two others with ABiMed. We recorded the problems identified by the pharmacists, the interventions proposed, the response time, the perceived usability and the comments. Pharmacists' medication reviews were compared to an expert-designed gold standard. Results: With ABiMed, pharmacists found 1.6 times more relevant drug-related problems during the medication review (p=1.1e-12) and proposed better interventions (p=9.8e-9), without needing more time (p=0.56). The System Usability Scale score is 82.7, which is ranked "excellent". In their comments, pharmacists appreciated the visual aspect of ABiMed and its ability to compare the current treatment with the proposed one. A multifactor analysis showed no difference in the support offered by ABiMed according to the pharmacist's age or sex, in terms of percentage of problems identified or quality of the proposed interventions. Conclusions: The use of an intelligent and visual clinical decision support system can help pharmacists when they perform medication reviews. Our main perspective is the validation of the system in clinical conditions.
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