Development of a standardized knowledge base to generate individualized medication plans automatically with drug administration recommendations

Abstract

AIMSWe aimed to develop a generic knowledge base with drug administration recommendations which allows the generation of a dynamic and comprehensive medication plan and to evaluate its comprehensibility and potential benefit in a qualitative pilot study with patients and physicians. METHODSBased on a literature search and previously published medication plans, a prototype was developed and iteratively refined through qualitative evaluation (interviews with patients and focus group discussions with physicians). To develop the recommendations for safe administration of specific drugs we screened the summary of product characteristics (SmPC) of different exemplary brands, allocated the generated advice to groups with brands potentially requiring the same advice, and reviewed these allocations regarding applicability and appropriateness of the recommendations. RESULTSFor the recommendations, 411 SmPCs of 140 different active ingredients including all available galenic formulations, routes of administrations except infusions, and administration devices were screened. Finally, 515 distinct administration recommendations were included in the database. In 926 different generic groups, 29 879 allocations of brands to general advice, food advice, indications, step-by-step instructions, or combinations thereof were made. Thereby, 27 216 of the preselected allocations (91.1%) were confirmed as appropriate. In total, one third of the German drug market was labelled with information. CONCLUSIONSGeneric grouping of brands according to their active ingredient and other drug characteristics and allocation of standardized administration recommendations is feasible for a large drug market and can be integrated in a medication plan. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Patients require information on how to administer drugs to prevent administration errors effectively, especially after hospital discharge.• Standardization and categorization of written instructions improves knowledge, recall and satisfaction of patients.

A randomized controlled trial to assess the effect of a medication plan containing drug administration recommendations on patients’ drug knowledge after 2 months

“…The questionnaire also included three questions relating to the individual drug therapy of the patient. Therefore, a catalog of questions was generated in advance that contained up to three preformulated questions for each active ingredient with drug information available in the EMP database . Subjects of the list were questions on indication and, if applicable, coordination of food with drug intake and drug handling during the treatment (e.g.…”

“…To provide patients with individual, standardized and written handling information tailored to their drugs, we developed a medication plan enhanced with graphical and textual drug information (enhanced medication plan, EMP) . The integration of the EMP in the hospital discharge process proved to immediately increase patients’ drug knowledge .…”

Memorandum on the Use of Information Technology to Improve Medication Safety

“…Nevertheless, ambitious projects on various issues related to health IT for medication safety can be found in several hospitals, e.g. Universitätsklinikum Heidelberg [30,31], Universitätsklinikum Erlangen [32,33], Universitätsklinikum Genf [34,35], Spital Thun [36], or Salzburger Landeskliniken [37], just to name a few. Projects in Germany based on health IT and medication safety are enjoying increasing attention thanks to the Federal Ministry for Health's Patient Safety Action Plan which initiated and coordinated a number of activities on medication safety, including the Figure 1 Relevant steps of the medication process, presenting starting points for functions of health IT for medication safety utilisation of health IT for medication safety [38].…”