Usability in Patient-Oriented Drug Interaction Checkers—A Scandinavian Sampling and Heuristic Evaluation

Abstract

Drug interactions are an important source of medical error and a topic of particular interest to patient audiences. Patients must be informed to be able to participate in decision-making affecting their health. This paper explores the availability of drug interaction checkers in Scandinavia and the prevalence and characteristics of usability issues preventing patients from benefiting from them. Drug interaction checkers were sampled and evaluated through heuristic evaluations. Issue-based data were analyzed through descriptive statistics, as well as single-case and cross-case qualitative analyses. The findings were interpreted side-by-side using a mixed-methods approach. The results showed a multitude of usability issues. Catastrophic issues indicating the safety of dangerous drug pairings were found in two of the checkers. Results also showed that the checkers lacked adaptive design, patient-oriented content, and adherence to basic design principles. A positive correlation was observed between system complexity and number of usability issues. We suggest that this comes from a lack of systematic design approach. The market for Scandinavian drug interaction checkers was as such characterized by a limited selection of checkers known to be used by patients for their utility, but failing to accommodate them in terms of system quality.

Patients’ Use and Perceptions of a Drug-Drug Interaction Database: A Survey of Janusmed Interactions

“…This is in line with previous research describing that patients’ sources of drug information and information about DDIs are primarily physicians, pharmacists, relatives, patient information leaflets and online sources [ 44 , 45 , 46 ]. Internationally there are different mobile apps and web pages that provide DDI services to patients, but research regarding patients use of them is limited [ 19 , 20 , 25 ]. Previous studies have shown that patients often have limited knowledge and awareness regarding DDIs [ 38 , 47 ].…”

“…Previous studies suggest that among patients there is a need of “rather diverse but only limited information domains” regarding DDI [ 18 ]. Vingen et al [ 20 ] state that in order for patients to act as decision-makers regarding their own health, we need to empower them with information. The systems conveying this information must be usable in order for empowerment to take place.…”

“…CDSS may improve practitioner performance; however, for such systems to work the data must be of high quality and presented in a user-friendly way to assure both safety and the accuracy of the system [ 3 , 16 , 17 ]. Several studies have been published assessing professional DDI-checkers, although the existence of and knowledge about DDI-checkers for patients/public is sparse [ 7 , 8 , 18 , 19 , 20 ].…”

Current Knowledge about Providing Drug–Drug Interaction Services for Patients—A Scoping Review

“…Similarly, the study by Vingen et al reports on available DDI website checkers in Scandinavian market [38]. They identified three Norwegian (Interaksjoner.no, Felleskatalogen.no, Legemiddelsok.no), two Danish (Medicinkombination.dk and Interaktionsdatabasen.dk), and one Swedish (Janusmed) service.…”

“…The reasons include: perceived complexity of information; fear of creating patient anxiety, which could lead to patients not taking their medication; or increased concerns and unnecessary questions to health care professionals [33]. There are already some apps or services available for patients to check for DDI indicating an existing need or demand among patients [34][35][36][37][38]. However, there is limited knowledge about any effects or if their design or content is appropriate for patients.…”