Medicines are a cornerstone of medicine, but sometimes doctors make mistakes when prescribing them and patients do not take them properly.
A new AI tool developed at the University of Oxford aims to tackle both problems. DrugGPT provides physicians with a safety net when they prescribe medications and provides them with information that can help their patients better understand why and how to take them.
Doctors and other healthcare professionals who prescribe medications can get an instant second opinion by entering a patient’s condition into the chatbot. Prototype versions respond with a list of recommended medications and flag possible side effects and drug interactions.
“One of the great things is that it then explains why,” says Prof. David Clifton, whose team at the AI for Healthcare laboratory in Oxford led the project.
“It will show you the guidelines – the research, flowcharts and references – and why it recommends this particular drug.”
Some doctors are already using mainstream generative AI chatbots like ChatGPT and Google’s Gemini (formerly Bard) to check their diagnoses and write medical notes or letters. International medical associations have previously advised doctors against using these tools, partly due to the risk that the chatbot will provide false information, or what technologists call hallucinations.
But Clifton and his colleagues say in a preliminary report on DrugGPT’s effectiveness that it “delivers performance competitive with human experts” on U.S. medical licensing exams.
“Imagine you’re a general practitioner: you’re trying to stay abreast of a countless number of medical guidelines that are updated every year. It’s difficult,” says Clifton, who is also a research professor at the National Institute for Health and Care Research (NIHR), which has supported the project.
“But it is important not to leave people out of the picture. You don’t want the ‘computer says no’ problem. It should always be an advice for a person like a co-pilot. It is a safety net: here is a recommendation against which you can compare your recommendation.”
Other research published by the British medical journal estimate that approximately 237 million medication errors are made in England every year, costing around £98 million and claiming more than 1,700 lives. Only around 2% of errors could potentially lead to serious harm, the study found, with GPs making the fewest errors and care home prescribers the most.
Patients also make mistakes with medications. “Non-compliance”, where patients fail to take medicines as instructed by a doctor, wastes around £300 million a year for NHS England, according to the Pharmaceutical Journal.
GP practices are already using technology such as ScriptSwitch, which controls medication options and allows prescribers to choose cheaper options.
Dr. Lucy Mackillop, an obstetrician at Oxford University Hospitals NHS Foundation Trust who advised Clifton’s team, said the potential benefit of DrugGPT was that it would give busy doctors more information about the medicines they were prescribing.
“If you discuss it with the patient, he or she is more likely to understand and manage the medication. Therefore, it is more likely that the medication will generally work and do what it is intended to do,” she says.
Dr. Michael Mulholland, vice-chairman of the Royal College of GPs, said prescriptions were dispensed correctly in the vast majority of cases.
But “doctors are only human and mistakes can happen, especially when doctors work under high workload and staff pressure, as GPs and our teams currently do. This is especially true in patients who take many medications at the same time, as there are many different ways in which the medications can interact with each other.
“We are always open to introducing more advanced security measures that will help us minimize human error – we just need to ensure that new tools and systems are robust and that their use is tested before being rolled out more widely to avoid unforeseen and unintended consequences.
“Ultimately, the most effective, sustainable solution for delivering safe patient care is to ensure that primary care practices are adequately funded and staffed, with sufficient numbers of GPs and other healthcare professionals working at a safe level.”