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UBC Theses and Dissertations

Pilot study of drug therapy decision making through instant group conferencing Esmail, Laura Caroline

Abstract

Objective: To develop and pilot test the feasibility and usefulness of a drug therapy decision support system aimed to influence general medical practitioners' (GPs) drug therapy decision-making at the time of patient care. Sample: Over 6 months, 13 GPs and 3 clinical pharmacists (CPs) from ambulatory medical practice sites across British Columbia participated in the study. Methodology: GPs had immediate access to a network of CPs and other GPs through cellular telephone-based instant group conferencing. GPs initiated instant conference calls when faced with complex drug-related patient cases. The system contacted all participants on the network simultaneously. GPs and CPs accepting the call participated in a brief teleconference (mean, 3min 42sec; range, lmin 22sec - 9min 33sec), discussed the case and provided decision support. Conference calls were recorded and cellular telephone bills provided data on study calls. GPs completed impact assessment questionnaires after each call initiated, indicating the impact of the conference on their patient care decision. Exit questionnaires assessed perceived system advantages and limitations. System feasibility and usefulness was determined through quantitative and qualitative analysis of 1) call frequency, duration, 2) impact assessment questionnaires and 3) exit questionnaires. Results: Participants initiated 59 calls. Forty-three of 59 calls (72.9%) were answered by another participant. Twenty-three of 43 calls involved 2 participants, 14 (32.6%) involved 3 participants and 6 (14%) involved 3 or more participants. Twenty-nine of 34 impact assessment forms (85.3%) stated the call assisted them in making their patient care decision. Six of 13 participants (46.2%) agreed this was a feasible system. Eight participants (61.5%) agreed this was a useful system. Main system issues were technical problems and recruitment and retention of both GPs and CPs. Conclusion: Cellular telephone-based instant group conferencing between GPs and CPs is a useful method for influencing drug therapy decisions at the time of patient care. The feasibility of this system is difficult to fully assess at this early stage of system development. If recommendations are implemented in the next phase of research, the system will likely have enhanced feasibility. Recommendations include simplifying the technology and increasing the sample size of GPs and CPs.

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