Development of GESDUA: A Mobile Health Application to Reduce Potentially Inappropriate Medications in Geriatric Prescriptions
Laksmi Maharani1*, Fita Rahmawati2, Zullies Ikawati2, Mustofa3

(1) Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University
(2) Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Gadjah Mada University
(3) Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University

Corresponding author: Laksmi Maharani (laksmi.maharani[at]unsoed.ac.id)

Abstract

Background: Potentially inappropriate medications (PIM) are prevalent in 33-63% of geriatric prescriptions in Indonesia, posing substantial risks to patient safety. While explicit PIM criteria are available for screening, their routine application in clinical practice remains limited. Digital health solutions offer an opportunity to integrate evidence-based screening into prescribing workflows.
Purpose: This study aimed to develop and evaluate the Geriatric Safe Drugs Use Application (GESDUA), a mobile- and web-based tool designed to reduce PIM in geriatric care.
Methods: A research and development design were employed using the ADDIE instructional design framework to create the GESDUA. The process involved: (1) needs analysis through focus group discussions- (2) application design and development- (3) early evaluation through content validity, criterion validity, and reliability testing- (4) implementation via pilot testing using a pre-post design involving 33 patients at the geriatric clinic of Dr. Sardjito General Hospital, Yogyakarta, to assess the impact of GESDUA on reducing PIM- and (5) final evaluation of user satisfaction among 22 physicians and pharmacists in a cross-sectional survey.
Results: GESDUA^s main features include PIM analysis, potential drug-drug interaction analysis, and recommendations for drug use in patients with renal impairment. During implementation, GESDUA reduced PIM prevalence by 6.01% (p > 0.05). The user satisfaction index was 78.63%, indicating a high level of satisfaction.
Conclusion: GESDUA is a novel, evidence-based digital intervention that supports safer prescribing for older adults. While initial implementation reduced PIM prevalence modestly, broader, and more targeted deployment is warranted to achieve significant clinical impact.

Keywords: potentially inappropriate medications, geriatrics, digital health

Topic: Pharmaceutical Sciences and Clinical Pharmacy