{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:07:18Z","timestamp":1792130838058,"version":"4.4.0"},"reference-count":62,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":44,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006636","name":"Swedish Research Council for Health, Working Life and Welfare","doi-asserted-by":"crossref","award":["2014\u20134990"],"award-info":[{"award-number":["2014\u20134990"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n                  <jats:p>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.<\/jats:p>\n                  <jats:p>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\u2014the 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.<\/jats:p>\n                  <jats:p>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.<\/jats:p>\n                  <jats:p>Patient participation by self-reporting symptoms via a PCDSS can contribute to safer drug use.<\/jats:p>","DOI":"10.1055\/a-2641-0265","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:19:33Z","timestamp":1763165973000},"page":"1709-1719","source":"Crossref","is-referenced-by-count":2,"title":["Patient Participation in Monitoring Potential Adverse Drug Events"],"prefix":"10.1055","volume":"16","author":[{"given":"Kerstin","family":"Jors\u00e4ter Blomgren","sequence":"additional","affiliation":[{"name":"School of Health, Care and Social Welfare, M\u00e4lardalen University, Eskilstuna, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Fastbom","sequence":"additional","affiliation":[{"name":"Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.archger.2015.11.010","article-title":"Time trends in 20 years of medication use in older adults: Findings from three elderly cohorts in Stockholm, Sweden","volume":"63","author":"\u00c5G Craftman","year":"2016","journal-title":"Arch Gerontol Geriatr"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.cger.2012.01.007","article-title":"Pharmacokinetics and pharmacodynamic changes associated with aging and implications for drug therapy","volume":"28","author":"L C Sera","year":"2012","journal-title":"Clin Geriatr Med"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1517\/14740338.2013.827660","article-title":"Clinical consequences of polypharmacy in elderly","volume":"13","author":"R L Maher","year":"2014","journal-title":"Expert Opin Drug Saf"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s40266-015-0242-4","article-title":"National indicators for quality of drug therapy in older persons: the Swedish experience from the first 10 years","volume":"32","author":"J Fastbom","year":"2015","journal-title":"Drugs Aging"},{"issue":"S 01","key":"ref5","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/BF03319101","article-title":"Adverse drug events as a cause of hospitalization in older adults","volume":"35","author":"F Salvi","year":"2012","journal-title":"Drug Saf"},{"issue":"35","key":"ref6","first-page":"2338","article-title":"L\u00e4kemedelsbiverkan vanlig orsak till sjukhusv\u00e5rd av aldre. En klinisk retrospektiv studie","volume":"105","author":"E Paul","year":"2008","journal-title":"Lakartidningen"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1177\/0272989X15613530","article-title":"The impact of patient participation in health decisions within medical encounters: a systematic review","volume":"36","author":"M L Clayman","year":"2016","journal-title":"Med Decis Making"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1111\/hex.12515","article-title":"Communication and patient participation influencing patient recall of treatment discussions","volume":"20","author":"C Richard","year":"2017","journal-title":"Health Expect"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1007\/s11606-016-3980-z","article-title":"A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations","volume":"32","author":"S M Shortell","year":"2017","journal-title":"J Gen Intern Med"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1136\/bmjqs-2015-004357","article-title":"A systematic review of reliable and valid tools for the measurement of patient participation in healthcare","volume":"25","author":"N M Phillips","year":"2016","journal-title":"BMJ Qual Saf"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s40271-017-0270-8","article-title":"Evaluation of patient and family engagement strategies to improve medication safety","volume":"11","author":"J M Kim","year":"2018","journal-title":"Patient"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1177\/2374373517727532","article-title":"Towards a more patient-centered approach to medication safety","volume":"5","author":"J L Lee","year":"2018","journal-title":"J Patient Exp"},{"issue":"12","key":"ref14","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1001\/archinte.163.12.1409","article-title":"Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review","volume":"163","author":"R Kaushal","year":"2003","journal-title":"Arch Intern Med"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.7326\/0003-4819-157-1-201207030-00450","article-title":"Effect of clinical decision-support systems: a systematic review","volume":"157","author":"T J Bright","year":"2012","journal-title":"Ann Intern Med"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/1748-5908-6-87","article-title":"Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes","volume":"6","author":"N M Souza","year":"2011","journal-title":"Implement Sci"},{"issue":"09","key":"ref17","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1136\/bmjqs-2013-002165","article-title":"Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review","volume":"23","author":"S R Ranji","year":"2014","journal-title":"BMJ Qual Saf"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/2046-4053-3-56","article-title":"The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis","volume":"3","author":"T K Nuckols","year":"2014","journal-title":"Syst Rev"},{"issue":"23","key":"ref19","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.2146\/ajhp170870","article-title":"Systematic review of computerized prescriber order entry and clinical decision support","volume":"75","author":"M V\u00e9lez-D\u00edaz-Pallar\u00e9s","year":"2018","journal-title":"Am J Health Syst Pharm"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s13012-017-0644-2","article-title":"What hinders the uptake of computerized decision support systems in hospitals? 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