Barriers and Facilitators Influencing Real-Time & Digital Based Reporting of Adverse Drug Reactions by Community Pharmacists: a qualitative study using the Task Technology Fit Framework (Preprint)

Exploring willingness to use adverse drug reaction reporting systems: a multicentre qualitative study in China based on the technology acceptance model and task-technology fit integration approach

BACKGROUND

Adverse drug reaction (ADR) reporting systems are critical for monitoring and managing drug safety. However, various factors influence the willingness to use these systems. This study aimed to investigate the willingness to use ADR reporting systems through an integrated model of the Technology Acceptance Model (TAM) and Task-Technology Fit (TTF) theory, conducting a multicentre qualitative study from the user's perspective.

METHODS

This study used qualitative research methods, including in-depth interviews with clinicians, nurses, pharmacists and administrators who reported ADRs through the National Adverse Drug Reaction Monitoring System (NADRMS) and the China Hospital Pharmacovigilance System (CHPS). The interviews were audio-recorded, transcribed verbatim and analysed using QDA Miner software for data management and thematic analysis.

RESULTS

Eighteen healthcare workers from five healthcare organisations participated in the study. They found the ease of use and usefulness of the current NADRMS and CHPS to be acceptable. The essential technical requirements identified included accuracy, standardisation, timeliness and confidentiality. However, challenges such as inaccurate information capture, unstable interfacing with medical record systems, low reporting efficiency and lack of data sharing were highlighted. Overall, front-line healthcare workers exhibited a generally negative attitude towards using NADRMS and CHPS, driven more by necessity than preference. Factors influencing their willingness to use these systems included ease of use, practicality, risk perception and social impact, with varying attitudes and requirements observed between user groups.

CONCLUSION

This study provides practical recommendations that can be readily implemented to enhance the effectiveness and sustainability of ADR reporting systems. While front-line users in China acknowledged the systems' ease of use and usefulness, they also noted significant gaps in technological adaptation. They expressed the need for improvements in data openness and sharing, accessibility and system intelligence.

A Web-Based Tool to Report Adverse Drug Reactions by Community Pharmacists in Australia: Usability Testing Study

BACKGROUND

Adverse drug reactions (ADRs) are unintended and harmful events associated with medication use. Despite their significance in postmarketing surveillance, quality improvement, and drug safety research, ADRs are vastly underreported. Enhanced digital-based communication of ADR information to regulators and among care providers could significantly improve patient safety.

OBJECTIVE

This paper presents a usability evaluation of the commercially available GuildCare Adverse Event Recording system, a web-based ADR reporting system widely used by community pharmacists (CPs) in Australia.

METHODS

We developed a structured interview protocol encompassing remote observation, think-aloud moderating techniques, and retrospective questioning to gauge the overall user experience, complemented by the System Usability Scale (SUS) assessment. Thematic analysis was used to analyze field notes from the interviews.

RESULTS

A total of 7 CPs participated in the study, who perceived the system to have above-average usability (SUS score of 68.57). Nonetheless, the structured approach to usability testing unveiled specific functional and user interpretation issues, such as unnecessary information, lack of system clarity, and redundant data fields-critical insights not captured by the SUS results. Design elements like drop-down menus, free-text entry, checkboxes, and prefilled or auto-populated data fields were perceived as useful for enhancing system navigation and facilitating ADR reporting.

CONCLUSIONS

The user-centric design of technology solutions, like the one discussed herein, is crucial to meeting CPs' information needs and ensuring effective ADR reporting. Developers should adopt a structured approach to usability testing during the developmental phase to address identified issues comprehensively. Such a methodological approach may promote the adoption of ADR reporting systems by CPs and ultimately enhance patient safety.

Linking Activity Theory Within User-Centered Design: Novel Framework to Inform Design and Evaluation of Adverse Drug Reaction Reporting Systems in Pharmacy

BACKGROUND

Adverse drug reactions (ADRs) may cause serious injuries including death. Timely reporting of ADRs may play a significant role in patient safety; however, underreporting exists. Enhancing the electronic communication of ADR information to regulators and between health care providers has the potential to reduce recurrent ADRs and improve patient safety.

OBJECTIVE

The main objectives were to explore the low rate of ADR reporting by community pharmacists (CPs) in Australia, evaluate the usability of an existing reporting system, and how this knowledge may influence the design of subsequent electronic ADR reporting systems.

METHODS

The study was carried out in 2 stages. Stage 1 involved qualitative semistructured interviews to identify CPs' perceived barriers and facilitators to ADR reporting. Data were analyzed by thematic analysis, and identified themes were subsequently aligned to the task-technology fit (TTF) framework. The second stage involved a usability evaluation of a commercial web-based ADR reporting system. A structured interview protocol that combined virtual observation, think-aloud moderating techniques, retrospective questioning of the overall user experience, and a System Usability Scale (SUS). The field notes from the interviews were subjected to thematic analysis.

RESULTS

In total, 12 CPs were interviewed in stage 1, and 7 CPs participated in stage 2. The interview findings show that CPs are willing to report ADRs but face barriers from environmental, organizational, and IT infrastructures. Increasing ADR awareness, improving workplace practices, and implementing user-focused electronic reporting systems were seen as facilitators of ADR reporting. User testing of an existing system resulted in above average usability (SUS 68.57); however, functional and user interpretation issues were identified. Design elements such as a drop-down menu, free-text entry, checkbox, and prefilled data fields were perceived to be extremely useful for navigating the system and facilitating ADR reporting.

CONCLUSIONS

Existing reporting systems are not suited to report ADRs, or adapted to workflow, and are rarely used by CPs. Our study uncovered important contextual information for the design of future ADR reporting interventions. Based on our study, a multifaceted, theory-guided, user-centered, and best practice approach to design, implementation, and evaluation may be critical for the successful adoption of ADR reporting electronic interventions and patient safety. Future studies are needed to evaluate the effectiveness of theory-driven frameworks used in the design and implementation of ADR reporting systems.