Artificial intelligence-supported web application design and development for reducing polypharmacy side effects and supporting rational drug use in geriatric patients

被引:18
作者
Akyon, Seyma Handan [1 ]
Akyon, Fatih Cagatay [2 ]
Yilmaz, Tarik Eren [1 ]
机构
[1] Univ Hlth Sci, Ankara City Hosp, Family Med Dept, Ankara, Turkiye
[2] Middle East Tech Univ, Grad Sch Informat, Ankara, Turkiye
关键词
artificial intelligence; computer-assisted decision making; drug interactions; family practice; geriatrics; multimorbidity; polypharmacy; potentially inappropriate medication list; POTENTIALLY INAPPROPRIATE MEDICATIONS; SCREENING TOOL; ALERT DOCTORS; POPULATION; CRITERIA; PRESCRIPTIONS; RISKS; LIST;
D O I
10.3389/fmed.2023.1029198
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: The main complications of polypharmacy, which is known as the simultaneous use of more than five drugs, are potentially inappropriate medicines(PIMs), drug-drug, and drug-disease interaction. It is aimed to prepare an auxiliary tool to reduce the complications of polypharmacy and to support rational drug use(RDU), by evaluating the patient with age, drugs, and chronic diseases in this study.Materials and methods: In the first phase of this study, as methodological research, an up-to-date and comprehensive auxiliary tool as a reference method was generated with a database containing interaction information of 430 most commonly used drug agents and chronic diseases in geriatrics in the light of current and valid 6 PIM criteria for geriatric patients, and medication prospectuses, relevant current articles, and guidelines. Then, an artificial intelligence(AI) supported web application was designed and developed to facilitate the practical use of the tool. Afterward, the data of a cross-sectional observational single-center study were used for the rate and time of PIM and drug interaction detection with the web application. The proposed web application is publicly available at .Results: While the PIM coverage rate with the proposed tool was 75.3%, the PIM coverage rate of EU(7)-PIM, US-FORTA, TIME-to-STOPP, Beers 2019, STOPP, Priscus criteria in the web application database respectively(63.5%-19.5%) from the highest to the lowest. The proposed tool includes all PIMs, drug-drug, and drug-disease interaction information detected with other criteria. A general practitioner detects interactions for a patient without the web application in 2278 s on average, while the time with the web application is decreased to 33.8 s on average, and this situation is statistically significant.Discussion: In the literature and this study, the PIM criteria alone are insufficient to include actively used medicines and it shows heterogeneity. In addition, many studies showed that the biggest obstacle to drug regulation in practice is "time constraints." The proposed comprehensive auxiliary tool analyzes age, drugs, and diseases specifically for the patient 60 times faster than the manual method, and it provides quick access to the relevant references, and ultimately supports RDU for the clinician, with the first and only AI-supported web application.
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页数:16
相关论文
共 86 条
[1]  
Akalın B, 2021, ACTA INFOLOGICA, V5, P231, DOI [10.26650/acin.750857, 10.26650/acin.850857, DOI 10.26650/ACIN.750857]
[2]  
Akdeniz M, 2017, Turkish Journal of Family Practice, V21, P74, DOI [10.15511/tahd.17.00274, 10.15511/tahd.17.00274, DOI 10.15511/TAHD.17.00274]
[3]  
Akici A., 2013, TURKIYE AILE HEKIMLI, V17, P125, DOI DOI 10.2399/TAHD.13.00003
[4]  
Akyon SH., 2022, ULUDA KONGRE KITAB 2, P205
[5]  
Allen J, 2002, BRIT J GEN PRACT, V52, P526
[6]  
[Anonymous], 2022, WORKIG SAFER PRESCRI
[7]  
Arslan SE., 2020, ANKARA SEHIR HASTANE
[8]  
Arslan ŞE, 2020, Ankara Medical Journal, V20, P1027, DOI [10.5505/amj.2020.24654, 10.5505/amj.2020.24654, DOI 10.5505/AMJ.2020.24654]
[9]  
Babalik A., 2007, SELCUK U J ENG SCI, V6, P109
[10]   Turkish inappropriate medication use in the elderly (TIME) criteria to improve prescribing in older adults: TIME-to-STOP/TIME-to-START [J].
Bahat, Gulistan ;
Ilhan, Birkan ;
Erdogan, Tugba ;
Halil, Meltem ;
Savas, Sumru ;
Ulger, Zekeriya ;
Akyuz, Filiz ;
Bilge, Ahmet Kaya ;
Cakir, Sibel ;
Demirkan, Kutay ;
Erelel, Mustafa ;
Guler, Kerim ;
Hanagasi, Hasmet ;
Izgi, Belgin ;
Kadioglu, Ates ;
Karan, Ayse ;
Kulaksizoglu, Isin Baral ;
Mert, Ali ;
Ozturk, Savas ;
Satman, Ilhan ;
Sever, Mehmet Sukru ;
Tukek, Tufan ;
Uresin, Yagiz ;
Yalcin, Onay ;
Yesilot, Nilufer ;
Oren, Meryem Merve ;
Karan, Mehmet Akif .
EUROPEAN GERIATRIC MEDICINE, 2020, 11 (03) :491-498