Table 1.
Characteristics of the included studies (n = 15).
| Author (year) | Country | Study design | Setting | Sample size | Health professionals’ category | Data collection method | Digital health tool | Description of tool | Type of treatment/drug | Patients’ subgroups | Quality assessment/(score obtained/total score) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Jeffries et al. (2021) a | England | Qualitative | Primary care | 29 | GP, N, Pharm, and PharmT | Interview | CDSS | Provided a suite of messages that appeared as alerts at the point of prescribing | Not directed to any specific pathology or treatment | Not targeted at any specific population | 7/7 |
| Catho et al. (2020) | Switzerland and France | Qualitative | Hospital | 29 | Phys | Interview | CDSS | Recommendations embedded into the EHR and the CPOE system | Antimicrobial | Not targeted at any specific population | 7/7 |
| Jung et al. (2020) | South Korea | Mixed methods | Hospital | 61 (quantitative); 15 (qualitative) | Phys | Survey (quantitative); interview (qualitative) | Medication Decision Support System (CDSS) | MDSS in EHR with alert screens; prescription drug monitoring program | Not directed to any specific pathology or treatment | Not targeted at any specific population | 15/17 |
| Rieckert et al. (2018) | Germany | Qualitative | Primary care | 21 | GP | Interview | CDSS | CMR on the screen displaying recommendations regarding missing indications, necessary laboratory tests, evidence-based current medication, dose adjustments, potentially harmful drug-drug interactions, contra-indications, and possible adverse drug events | Several guidelines were used to access medication appropriateness | Older patients (aged 75 and older) taking at least 8 drugs | 7/7 |
| Koskela et al. (2016) | Finland | Qualitative | Primary care | 21 | Phys (9) and N (12) | Focus groups | CDSS | Evidence-based MEDS that provides patient-specific clinical recommendations or warnings in the form of reminders and links to guidelines. Contains CMR where is available guidance for an individual patient on drug therapy | Not directed to any specific pathology or treatment | Not targeted at any specific population | 7/7 |
| Lugtenberg et al. (2015) | Netherlands | Qualitative | Primary care | 24 | GP and N | Focus groups | CDSS | It provides evidence-based patient-specific advice during consultation in terms of patient data registration, drug prescription and management; in case of a discrepancy between current (guidelines) and advised care, an alert is sent | Cardiovascular risk management, Asthma/COPD, Diabetes mellitus type II, Thyroid disorders, Viral hepatitis and other liver diseases, Atrial fibrillation and Subfertility, Gastro protection and Chronic renal failure | Not targeted at any specific population | 7/7 |
| Charani et al. (2013) | UK | Mixed methods | Hospital | 81 (quantitative); not reported (qualitative) | Physc and Pharm | Survey (quantitative); Focus groups (qualitative) | Smartphone application | Therapeutic drug monitoring and clinical calculators | Antibiotic | Not targeted at any specific population | 13/17 |
| Litvin et al. (2012) | USA | Mixed methods | Primary care | 39 | Phys (33) and N (6) | Data extracted from the EHR (quantitative); Interview (qualitative) | CDSS | Diagnostic criteria; prompts regarding appropriate antibiotic use; first-line antibiotics recommendations; educational material | Antibiotic for acute respiratory infections | Not targeted at any specific population | 14/17 |
| Vedel et al. (2012) | Canada | Qualitative | Primary care | 31 | Phys, N, and Pharm | Interview | CDSS | Traditional EMR functionalities plus advanced features, such as decision-support tools, patient-centred goal setting, and interdisciplinary functionalities | Not directed to any specific pathology or treatment | Multimorbid patients | 7/7 |
| Campion et al. (2011) | USA | Qualitative | Hospital | 37 | N | Direct observation and interviews | CDSS | Calculates insulin rates using a linear equation explaining the recommendations | Intensive insulin therapy in the surgical and trauma intensive care units | Not targeted at any specific population | 5/7 |
| Hor et al. (2010) | Ireland | Cross-sectional (quantitative) | Primary care | 98 | GP | Survey | CDSS within electronic prescribing | An algorithm that establishes the safety and appropriateness of a prescription, with links to an information system employed to enhance the safety of the prescription. This may include clinical checks which allow alerts to be flagged up to the prescribers on drug-drug interactions or formulary status | Not directed to any specific pathology or treatment | Not targeted at any specific population | 6/7 |
| Weingart et al. (2009) | USA | Qualitative | Ambulatory care | 25 | Phys (21), N (3), and PhysA (1) | Focus groups | Electronic prescribing system | A linked desktop and handheld electronic prescribing system with a variety of drug allergy and interaction alerts, medication pick lists with default dosing, the ability to create favourite prescriptions, formulary tiers tied to patient's insurance type, and the ability to transmit prescriptions to the pharmacy electronically | Not directed to any specific pathology or treatment | Not targeted at any specific population | 7/7 |
| Varonen et al. (2008) | Finland | Qualitative | Primary and secondary care | 39 | Phys (22 primary care, 17 sary care) | Focus groups | CDSS | Evidence-based MEDS with several updated guidelines | Not directed to any specific pathology or treatment | Not targeted at any specific population | 6/7 |
| Schectman et al. (2005) | USA | Not reported (quantitative) | Academic internal medicine residency training clinic | 84 | Phys | Survey | Computer-based prescription expert system (electronic prescribing system) | Enables electronic maintenance of a medication list, printing and renewing prescriptions, and checks drug-drug and drug-allergy interactions | Not directed to any specific pathology or treatment | Not targeted at any specific population | 6/7 |
| Bury et al. (2004) | UK | Mixed methods | Pediatric Oncology Centres and Pediatric Oncology Shared Care Units | 36 | Clinicians | Survey (quantitative); Interview (qualitative) | Web-based decision support system (CDSS) | A shared electronic record of treatment during continuing therapy, making haematology results, dosage history and other clinical data accessible; provides protocol-based decision support for clinicians when modifying doses of oral chemotherapy – the system advises on any modifications to the level of both oral chemotherapeutic agents for that week and presents an explanation for its proposal | Chemotherapy for Acute Lymphoblastic Leukemia | Children | 9/17 |
CDSS: clinical decision support system; CMR: comprehensive medication review; COPD: chronic obstructive pulmonary disease; CPOE: computerized physician order entry; EHR: electronic health record; EMR: electronic medical record; GP: general practitioner; HCP: healthcare professionals; MDSS: medication decision support system; MEDS: medicine electronic decision support; N: nurse; Pharm: pharmacist; PharmT: pharmacy technicians; Phys: physician; PhysA: physician assistant; UK: United Kingdom; USA: United States of America
a
Studies in which HCPs are a part of a heterogeneous sample but it is possible to distinguish their concrete opinions; the sample size reported corresponds only to HCPs.