Can software assist the home medicines review process by identifying clinically relevant drug-related problems?

Introduction. Home medicines reviews (HMRs) are conducted by accredited pharmacists to detect and address drug-related problems (DRPs), to improve the quality use of medication. Identification of DRPs involves an assessment of existing drug treatment in conjunction with other factors. Australian decision support software, Medscope Medication Review Mentor (MRM), has been developed to assist the identification and resolution of DRPs. Aim. This study assessed the ability of MRM to identify clinically relevant DRPs and to provide suitable recommendations for DRP resolution. Methods. HMR information and pharmacist-identified DRPs and recommendations were obtained from a database of almost 700 Australian HMRs collected for another project. The HMR information was entered into MRM and findings were recorded. A random sample of 20 HMRs with DRPs found by pharmacists (N=73) and MRM (N=125), were independently assessed by a panel of 12 clinical pharmacology and pharmacy experts. Experts were blinded to each source of DRPs and provided Likert scale responses regarding clinical relevance and recommendation appropriateness. Results. Experts agreed that the pharmacists (645 of 876 opinions; 74%) and MRM (1092 of 1500; 73%) identified clinically relevant DRPs. There was no significant difference between pharmacists and MRM regarding clinical relevance (Wilcoxon Rank Sum Test, W = 674591, p = 0.212). There was a significant difference regarding recommendation appropriateness (W = 568346, p < 0.001) reflecting greater support for MRM’s recommendations. Discussion. MRM identified more DRPs than pharmacists but not at a cost of irrelevance. The software’s recommendations compared favourably with those of the pharmacists. MRM appears capable of identifying clinically relevant DRPs and providing appropriate recommendations for DRP resolution.