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Appl Clin Inform 2025; 16(05): 1709-1719
DOI: 10.1055/a-2641-0265
Research Article

Patient Participation in Monitoring Potential Adverse Drug Events

Autoren

  • Kerstin Jorsäter Blomgren

    1   School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden

  • Johan Fastbom

    2   Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden

Funding The research was supported by the Swedish Research Council for Health, Working Life and Welfare (Forte; J.F., grant no.: 2014–4990).
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Abstract

Background

Clinical decision support systems (CDSS) have been suggested to be helpful in detecting and preventing drug-related problems such as adverse drug events (ADEs). However, patient participation systems monitoring self-reported data, such as symptoms, are still sparsely described in the literature.

Objectives

This study aimed to investigate if the use of a patient participating CDSS (PCDSS) can facilitate early detection of ADEs, thereby contributing to safer drug treatment in older adults.

Methods

A 1-year prospective observational study of elderly patients using a free web-based PCDSS to register symptoms over time at home. Initially, the PCDSS analyzed the extent and quality of the patient's drug use, based on a Swedish national set of criteria, and assessed drug-related symptoms using a standardized scale (PHASE-20). Thereafter, the patients recorded symptoms at home for 1 year—the first 6 months in free text, the second 6 months selecting from 19 predefined symptoms. The PCDSS signaled when symptoms were registered on three occasions in a 3-week period. The patient was then asked to contact his/her nurse at the healthcare center (HCC) for assessment of the symptoms and decisions on further contacts with the nurse or doctor. We analyzed the extent of signals generated, accompanying contacts, and associated medication reviews and adjustments.

Results

The 48 study participants registered 1,275 symptoms during the monitoring period, 61% by women. The PCDSS generated a total of 171 signals, of which 58% from women. Seventy-one percent (121) occurred under the first registration (free text) period. Of all signals, 44% (75) led to activities at the HCC, of which 48% (36) were physician contacts. In total, they contributed to medication reviews in 42% (15) and medication adjustments in 64% (23), with a total of 33 adjustments.

Conclusion

Patient participation by self-reporting symptoms via a PCDSS can contribute to safer drug use.

Keywords

clinical decision support - adverse drug event - self-reporting - medication review

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed by the Regional Ethical Review Board in Sweden (approval no.: 2016/1494–31/4; 2017/1072–32).




Publikationsverlauf

Eingereicht: 10. Dezember 2024

Angenommen: 22. Juni 2025

Artikel online veröffentlicht:
14. November 2025

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