title: An investigation into drug-related problems identifiable by commercial medication review software.
abstract: BACKGROUND
  Accredited pharmacists conduct home medicines reviews (HMRs) to detect and resolve potential drug-related problems (DRPs). A commercial expert system, Medscope Review Mentor (MRM), has been developed to assist pharmacists in the detection and resolution of potential DRPs.
  
  
  OBJECTIVE
  This study compares types of DRPs identified with the commercial system which uses multiple classification ripple down rules (MCRDR) with the findings of pharmacists.
  
  
  METHODS
  HMR data from 570 reviews collected from accredited pharmacists was entered into MRM and the DRPs were identified. A list of themes describing the main concept of each DRP identified by MRM was developed to allow comparison with pharmacists. Theme types, frequencies, similarity and dissimilarity were explored.
  
  
  RESULTS
  The expert system was capable of detecting a wide range of potential DRPs: 2854 themes; compared to pharmacists: 1680 themes. The system identified the same problems as pharmacists in many patient cases. Ninety of 119 types of themes identifiable by pharmacists were also identifiable by software. MRM could identify the same problems in the same patients as pharmacists for 389 problems, resulting in a low overlap of similarity with an averaged Jaccard Index of 0.09.
  
  
  CONCLUSIONS
  MRM found significantly more potential DRPs than pharmacists. MRM identified a wide scope of DRPs approaching the range of DRPs that were identified by pharmacists. Differences may be associated with system consistency and perhaps human oversight or human selective prioritisation. DRPs identified by the system were still considered relevant even though the system identified a larger number of problems.
authors.affiliation: School of Pharmacy, University of Tasmania.
authors.forename: Colin
authors.initials: C
authors.lastname: Curtain
authors.forename: Ivan
authors.initials: I
authors.lastname: Bindoff
authors.forename: Juanita
authors.initials: J
authors.lastname: Westbury
authors.forename: Gregory
authors.initials: G
authors.lastname: Peterson
keywords: Clinical decision support system; MCRDR; home medicines review; pharmacy practice