Design of a graphical and interactive interface for facilitating access to drug contraindications, cautions for use, interactions and adverse effects

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Lamy JB, Venot A, Bar-Hen A, Ouvrard P, Duclos C. Design of a graphical and interactive interface for facilitating access to drug contraindications, cautions for use, interactions and adverse effects. BMC Med Inform Decis Mak. 2008 Jun 2;8:21

Introduction: Serious adverse drug events are increasing at a rate four times faster than the total number of outpatient prescriptions. The error rate would decrease if physicians were more familiar with the contraindications, drug interactions, and cautions for use for medications they prescribe. The sources of the drug information in this study were the drug monographs from the French drug database called Theriaque. Reading a drug monograph, in general, is time consuming for a physician and requires cognitive effort, so it would be beneficial if a more usable representation of this information could be made available to doctors.

Objectives: This paper examines the usage of a graphical and interactive interface for physicians to quickly access and assess information about drug contraindications, cautions for use, and drug interactions. Using a graphical interface based on a graphical language developed by the authors, they showed that the use of a "GUI + text" approach to presenting the pertinent drug information shortened the time required for physicians to accurately acquire and assess the information, compared to the use of a text-only interface.

Methods: The authors created their own graphical, iconic language (VCM) with which they developed their graphical interface, called "Mister VCM". Mister VCM has two basic components. An interactive GUI, which is basically a simple diagram of a human body, in and around which are 29 graphical icons representing various anatomical, etiological, or life habit criteria of the patient. The other is the relevant portion text from the drug monograph which is displayed when the physician clicks on one of the icons that is lit up red. For example, for a medication that is contraindicated in patients with renal disease, a little kidney icon would be lit up for the physician to click on and get more information about that particular contraindication.

They tested a group of physicians' ability to read and remember the drug information presented by the investigators. The physicians had two different methods to obtain the information from the monographs: using the "GUI + text" of Mister VCM, or looking at a text-only representation of the entire drug monograph.

Results: Statistically compared to the text-only monograph, the speed and accuracy of the answers were signifcantly better with the GUI + text of Mister VCM. The use of Mister VCM allowed the physicians to answer the test questions, on average, in a little less than half the time, and with almost half the errors as with the text-only monograph. Subjectively compared, most of the participants said they had answered more accurately, and essentially all of them said they had answered more quickly with Mister VCM.

Conclusions: One of the more interesting conclusions of this study was how the graphical interface impacted the acquisition of implicit vs. explicit information in a drug monograph. Explicit information, in relation to a medication, is the presence of a contraindication, caution for usage, or drug interaction. Implicit information, on the other hand, is the absence of them. Therefore, implicit information is more difficult to obtain in a drug monograph, because the physician has to read the entire text to be sure a problem doesn't exist with the drug. With Mister VCM, the absence of any issue is clearly and simply represented graphically, by greying out all of the icons which have no relevance to the medication. --Mtotzke 22:36, 23 October 2008 (CDT)