Usability in Patient-Oriented Drug Interaction Checkers : A Scandinavian Sampling and Heuristic Evaluation

Abstract: Drug interactions are an important source of medical error. Studies have also shown it as a topic of particular interest to patients. To allow patients to participate in decision-making regarding their own health, they need to be empowered with information. This information must be provided through usable information systems. This thesis explored availability of drug interaction checkers in Scandinavia. It also explored the prevalence and characteristics of usability issues preventing patients from benefiting from these. Drug interaction checkers were sampled and described. Issue-based qualitative and quantitative data were gathered through heuristic evaluations. Patterns in the data were identified through descriptive statistics. Single-case and cross-case analyses explored emergent patterns in-depth. The findings were then interpreted side by side using a mixed-methods approach. The results showed the Scandinavian public faced with drug interaction checkers addressing healthcare professionals. They also showed a multitude of usability issues in these checkers. The issues were predominantly minor, but major issues were also identified in all but one of the checkers. Catastrophic usability issues were found in two of the checkers. These had the potential to lead patients to serious medical error. Results moreover showed the checkers lacking adaptive design, patient-oriented content, and a lack of adherence to basic design principles. A positive correlation was observed between system complexity and number of usability issues. This was suggested to result from lack of user-centered design approaches, or losing track of user goals while adding features over time. The result was a handful of generally professionally oriented drug interaction checkers known to be used by patients for their utility, but failing to accommodate them in terms of information and system quality. Empowering patients to participate in decision-making affecting their health asserts the need for developing patient-oriented information databases where these do not yet exist. These need to be presented through usable interfaces acknowledging patient behaviors.