‘Something that facilitates our work…rather than a hindrance’: Clinical pharmacist perspectives on the use of data analytics to support polypharmacy medication reviews in primary care

Abstract

Background: Polypharmacy and overprescribing pose an enormous challenge to safe healthcare and efficient use of resources. Patient record data could inform safer prescribing and deprescribing, but it is unclear how these complex data should be summarised and displayed to clinicians. The current study examined the perspectives of clinical pharmacists (CPs), a newly expanding workforce of primary care medication specialists, to explore ways that novel analytics could help improve health outcomes for frail and elderly (>65yrs) patients.Methods: Primary care clinical pharmacists (n=14) discussed examples and uses of analytics in a participatory design workshop. Data presented comprised of risk scores of negative outcomes for frail and elderly with polypharmacy derived from patient record data. Verbal and textual contributions were analysed using the framework method of exploratory content analysis. Results: Overarching themes of data uses, reservations and digital tools acceptance factors were identified. Participants valued several uses of polypharmacy analytics including clinical effects of drug-drug interactions, and risk scores to highlight high-risk patients (including cumulative medication risks). They expressed concerns that their current digital systems contribute to cognitive overload, and whether analytics could be relied upon. Experience of existing barriers mean that CPs’ acceptance of digital analytics tools is heavily contingent on ease of use, clear targeting and ability to support clinicians’ understanding and confidence in the strengths, limitations, and validity of using the analytics in patient care decisions. Conclusions: CPs would benefit from digital systems designed to better meet the needs of their role. Analytics from patient records could help address a concerning deficit in evidence of the real world clinical effects of polypharmacy medication interactions and help clinicians prioritise medication reviews. Clinical digital tools must be carefully designed to help, not hinder clinicians. Criteria are suggested to inform user-focused onward development of acceptable analytics.