Pharmacocybernetics
Pharmacocybernetics (also known as pharma-cybernetics, cybernetic pharmacy and cyberpharmacy) is an upcoming field that describes the science of supporting drugs and medications use through the application and evaluation of informatics and internet technologies, so as to improve the
Terminology
"Pharmaco" originates from the Greek word "pharmakon", which means drugs or poisons;[2] while "cybernetics" originates from the Greek word "kubernetes", which means "the art of steering".[3] Norbert Wiener first defined cybernetics as the science or study of "control and communication in the animal and the machine".[3][4] Since then, the American Society for Cybernetics has further described this field as "the design or discovery and application of principles of regulation and communication".[4]
Cybernetics also includes the concept of "cyberspace", which is described by the science fiction author William Gibson as a virtual representation of information in varying states of accessibility that is linked to various people and organizations in his book Neuromancer.[8][9][10] This concept is also reiterated in the movie "The Matrix" and its sequels, which revolves around Neo (Keanu Reeves), a computer programmer, who lives in a simulated matrix world created by sentient machines but perceived by humans as reality. The term "cyberspace" is now used ubiquitously to describe anything that is associated with computers, informatics and internet technologies, and also user experiences through interactions with these technologies.
Context
The increased popularity of informatics and internet technologies in healthcare has led to the development of various software, tools and applications for healthcare professionals and patients to improve pharmaceutical care and health-related outcomes.
Pharmaceutical care involves the identification, solving and prevention of medication/drug-related problems with regards to patients' drug therapies.[12] These problems are classified into various categories, which differ slightly between the American and European systems.
The American Society of Health-System Pharmacists classifies drug-related problems into eight major categories:[12]
- Untreated indications
- Medication use without indication
- Failure to receive medications
- Improper drug selections
- Underdose
- Overdose
- Adverse drug reactions
- Drug interactions
The Pharmaceutical Care Network Europe classifies them by problems and causes:[13]
Classification by problems:
- Treatment effectiveness
- Adverse reactions
- Treatment costs
- Other types of problems
Classification by causes:
- Drug selection
- Drug form
- Dose selection
- Treatment duration
- Drug use/administration process
- Logistics-related
- Patient-related
- Other causes
The rapid adoption of
- Digital dehumanization of the patient-practitioner relationship
- Virtual conflicts of recommendation
- Phenomenon of online self-prescribing
Pharmacocybernetics approaches target the whole
Types of environments
The types of environments that are relevant to pharmacocybernetics approaches follow
These environments, when applied to healthcare (for example, when a patient with a chronic disease searches the internet for information regarding his drug therapy), are as follows:- Microsystem (the patient’s immediate environment): The physical characteristics of the desktop or laptop, mouse sensitivity, or hardware and software faults that the patient experiences when performing the task.
- Mesosystem (the relation between the patient’s immediate environments): Whether the patient carries out the task alone or in the company of others will affect his experiences, psychological state and behavior.
- Exosystem (the external settings that indirectly affect but do not include the patient): When his family also understands his medical condition and drug therapy, they can provide encouragement and support which will prompt a sense of closeness experienced by the patient. This in turn may lead to improved medication compliance.
- Macrosystem (cultural context of the patient): Sharing of his experiences with other similar patients on social networking channels may alleviate the stigma felt and positively influence and enhance the experiences of the patient.
- Chronosystem (the time-space dimension over the patient’s course of life): As the patient gains more moral support in time from others with similar experiences, he can better adapt to life and may be motivated to improve his lifestyle and keep healthy.
Pharmacocybernetic maxims
Four pharmacocybernetic maxims have been defined for designers and developers of pharmaco-informatics tools and applications that provide information on medications and drug therapies.[1][15][16] These design principles are in relation to:
- Quality of drug information: The quality of the drug information provided by the tool/application should be accurate and evidence based. Its content should follow that from appropriate sources, such as research articles, established drug databases and drug package information.
- Quantity of drug information: The tool/application should provide adequate content regarding the medication or drug therapy so that its users have enough knowledge to minimize the likelihood of drug-related problems.
- Relation to target audiences: The medication- or drug-related content provided by the tool/application should be relevant to its target audience and clarify their doubts.
- Manner of data presentation: The information provided by the tool/application should be presented in a clear manner that avoids ambiguity and misinterpretation.
References
- ^ a b c d e Yap, KY; Chuang, X; Lee, AJM; Lee, RZ; Lim, L; Lim, JJ; Nimesha, R (2009). "Pharmaco-cybernetics as an interactive component of pharma-culture: empowering drug knowledge through user-, experience- and activity-centered designs". International Journal of Computer Science Issues. 3: 1–13.
- ^ Stedman TL. Stedman's Medical Dictionary. 28th ed. Baltimore, Maryland: Lippincott Williams & Wilkins; 2005.
- ^ a b Pangaro P. "Getting started" guide to cybernetics. Available at: http://pangaro.com/published/cyber-macmillan.html.
- ^ a b American Society for Cybernetics. Foundations - the subject of cybernetics: defining 'cybernetics'. Available at: http://www.asc-cybernetics.org/foundations/definitions.htm.
- S2CID 143822151.
- .
- JSTOR 216003.
- ^ Trappl R. The cybernetics and systems revival: Paper presented at: 14th European Meeting on Cybernetics and Systems Research (EMCSR'98); 14–17 April 1998; University of Vienna, Austrian Society for Cybernetic Studies.
- ^ Gibson W. Neuromancer (Special 20th Anniversary Edition). Hardcover ed: Ace Books; 2004.
- ^ PMID 19796753.
- ^ .
- ^ Pharmaceutical Care Network Europe. PCNE classification for drug-related problems v6.2. Available at: http://www.pcne.org/sig/drp/documents/PCNE%20classification%20V6-2.pdf.
- ^ Paquette D, Ryan J. Bronfenbrenner’s Ecological Systems Theory. Available at: "Archived copy" (PDF). Archived from the original (PDF) on 2007-09-28. Retrieved 2007-09-28.
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- PMID 20036470.