Utilizing a user-centered approach to develop and assess pharmacogenomic clinical decision support for thiopurine methyltransferase

Abstract

Background A pharmacogenomic clinical decision support tool (PGx-CDS) for thiopurine medications can help physicians incorporate pharmacogenomic results into prescribing decisions by providing up-to-date, real-time decision support. However, the PGx-CDS user interface may introduce errors and promote alert fatigue. The objective of this study was to develop and evaluate a prototype of a PGx-CDS user interface for thiopurine medications with user-centered design methods. Methods This study had two phases: In phase I, we conducted qualitative interviews to assess providers’ information needs. Interview transcripts were analyzed through a combination of inductive and deductive qualitative analysis to develop design requirements for a PGx-CDS user interface. Using these requirements, we developed a user interface prototype and evaluated its usability (phase II). Results In total, 14 providers participated: 10 were interviewed in phase I, and seven providers completed usability testing in phase II (3 providers participated in both phases). Most (90%) participants were interested in PGx-CDS systems to help improve medication efficacy and patient safety. Interviews yielded 11 themes sorted into two main categories: 1) health care providers’ views on PGx-CDS and 2) important design features for PGx-CDS. We organized these findings into guidance for PGx-CDS content and display. Usability testing of the PGx-CDS prototype showed high provider satisfaction. Conclusion This is one of the first studies to utilize a user-centered design approach to develop and assess a PGx-CDS interface prototype for Thiopurine Methyltransferase (TPMT). This study provides guidance for the development of a PGx-CDS, and particularly for biomarkers such as TPMT.

Clinical Decision Support and Implications for the Clinician Burnout Crisis

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Investigating Potential Drug-Drug Interactions in Pediatric and Adolescent Patients Receiving Chemotherapy

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“…Researchers have used varied methods, including interviews, surveys, observations, think‐aloud protocols, and heuristic evaluation to uncover user needs related to locating, integrating, and understanding information necessary to make PGx decisions. A user‐centered design approach was used to develop and evaluate PGx CDS for thiopurines 86 . The ensuing CDS was designed using human factors principles to improve the salience of important information (e.g., color coding mutation risks and actionable items), and minimize memory load on the user (e.g., grouping information into categories and integrating numerical information, such as laboratory values), which lead to high physician satisfaction.…”

“…A user‐centered design approach was used to develop and evaluate PGx CDS for thiopurines. 86 The ensuing CDS was designed using human factors principles to improve the salience of important information (e.g., color coding mutation risks and actionable items), and minimize memory load on the user (e.g., grouping information into categories and integrating numerical information, such as laboratory values), which lead to high physician satisfaction.…”