Using Medication Management Technologies in Swiss Primary Care: Mixed Methods Study

Abstract

Background: Medication management IT, such as shared electronic medication plans (eMediplan) and the Swiss Electronic Patient Record, is increasingly rolled out across Switzerland. They can support primary care physicians and older adults to optimize medication use and reduce medication-related harm. Understanding users’ expectations is essential for the implementation of medication management IT in primary care settings. Objective: This study aims to explore primary care physicians’ and older adults’ experiences and attitudes regarding medication management IT and identify barriers and facilitators to their use. Methods: We used a convergent mixed methods design using internet-based questionnaires and semistructured interviews with primary care physicians and older adults in Swiss primary care settings from January to August 2024. Participants included older adults aged ≥60 years who were using ≥2 prescribed medications daily, as well as primary care physicians practicing in Switzerland. Quantitative questionnaire data were analyzed using descriptive statistics to describe current use and attitudes regarding medication management IT. Qualitative data were analyzed using thematic analysis. Results: A total of 252 older adults (n=126, 50.0% female; mean age 73, SD 7 years) and 46 primary care physicians (n=15, 32.6% female; mean age 54, SD 11 years) completed the questionnaire. Notably, 7/252 (2.8%) older adults and 21/46 (45.7%) physicians reported using shared electronic medication plans. Most older adults reported not using the Swiss Electronic Patient Record (240/252, 95.2%) but expressed willingness to adopt it to manage (164/240, 68.3%) or share (179/240, 74.6%) their health information in the future. Most physicians were open to using digital tools for medication optimization (35/46, 76.1%) or a platform to coordinate medication optimization with patients and other health care providers (29/46, 63.0%). Interviews were conducted with 19 older adults (12/19, 63.2% female; mean age 77, SD 9 years) and 16 physicians (5/16, 31.3% female). The qualitative data helped explain the quantitative findings. Older adults rarely used medication management IT, while physicians mainly used basic tools integrated into their practice information system (eg, interaction checkers). Barriers and facilitators for both groups included information about these novel technologies, accessibility, perceived need and benefit, usability and accessibility, data protection, and required time and effort. Conclusions: Although older adults and primary care physicians perceived advantages of medication management IT, current use remains limited. Improving access, usability, and training for all stakeholders may facilitate broader adoption and enhance medication safety in interprofessional primary care settings.