| Summary: | 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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