gms | German Medical Science

Background/research question: Polypharmacy is associated with increased risks of adverse drug events due to medication errors. General practitioners (GPs) often lack a comprehensive overview of their patients’ medication due to prescriptions by specialists. This process evaluation investigates implementation and use of a computerized decision-support system (eMMa), granting full access to patients’ medical treatments, within a GP setting.

Methods: Evaluating implementation and use of eMMa is based on the Medical Research Council Guidance and its process evaluation framework. The process evaluation uses pseudonymized logbook entries of eMMa and comprises four dimensions: Reach examines to which extent the intended study population was included. Dose, Fidelity, and Tailoring examine how eMMa was used by GPs. The analyses were mainly explorative and descriptive.

Results: Study participants corresponded to the target population, although patients in greater need of care were treated less frequently. Despite GPs identifying and correcting prescription errors according to eMMa recommendations, both the intended intervention intensity and intervention goal of the process evaluation were rarely fulfilled.

Conclusion: The results of the process evaluation show that the implemented system has only been used in a subset of targeted patients and that only part of the recommendations have been followed. This must be taken into account when considering the effects of the intervention on patient-relevant outcomes. Furthermore, underreporting may have occurred since documentation of monitoring and changes in pharmacotherapy was not enforced. An improved use of eMMa could be achieved through more intensive training, data exchange of the software with practice information systems and collaboration in interprofessional teams, for example by involving pharmacists, which is substantiated in the literature.

Competing interests: Keine