Can agent-based simulation be used as a tool to support polypharmacy prescribing practice?. (30th May 2017)

• Record Type: Journal Article
• Authors: Chalk, Daniel; Manzi, Sean; Britten, Nicky; Kluettgens, Bettina; Magura, Ratidzai; Valderas, Jose
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 3:Number 3(2017)
• Page Start: 94
• Page End: 98
• Publication Date: 2017-05-30
• Subjects: Agent Based Simulation; Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2016-000162
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Objective: We sought to develop a simulation modelling method to help better understand the complex interplay of factors that lead to people with type 2 diabetes and asthma not taking all of their medication as prescribed when faced with multiple medications (polypharmacy). Research design and methods: In collaboration with polypharmacy patients, general practitioners, pharmacists and polypharmacy researchers, we developed a map of factors that directly and indirectly affect somebody’s decision to take their medication as prescribed when faced with multiple type 2 diabetes and asthma medications. We then translated these behavioural influences into logical rules using data from the literature and developed a proof-of-concept agent-based simulation model that captures the medicine-taking behaviours of those with type 2 diabetes and asthma taking multiple medications and which predicts both the clinical effectiveness and rates of adherence for different combinations of medications. Conclusions: The model we have developed could be used as a prescription support tool or a way of estimating medicine-taking behaviour in cost-effectiveness analyses.