Authors: Jonathon McLaughlin 1, Teerath Kumar Menghwar 2, David Gibson 1, Elaine Murray 1, Micheal McCann 2, Catriona Kelly 1, Laura Grimley 1, Annie Sellers 1

Affiliations: 1 Ulster University, Personalised Medicine Centre, Altnagelvin Hospital, Derry/Londonderry, Northern Ireland. 2 Atlantic Technological University, Department of Computing, Port Road, Letterkenny, Republic of Ireland

Background/ Introduction: Implementation of pharmacogenomics (PGx) in primary care requires digital tools that are not only structurally effective but also intuitive, low burden, and aligned with real clinical workflows. The initial iMPROVE REDCap build provided a direct transcription of the electronic case report form (eCRF), but early testing highlighted substantial usability barriers. To ensure the tool supported safe and efficient personalised prescribing, we undertook a structured programme of co development with clinicians and patients.

Material & Methods: The redesign followed an iterative co development process involving clinicians, researchers, and PPI contributors. We conducted structured alpha testing sessions to assess workflow alignment, data entry processes, narrative clarity, and operational safety. PPI workshops reviewed patient facing language, accessibility, and overall user experience. Insights from these activities informed a systematic re architecture of the project, including event arms, automated randomisation workflows, and dashboard guided pathways. Conditional and branching logic were developed to streamline data entry and support decision making, with automated survey invitations introduced to replace manual scheduling. Each iteration was reviewed and refined through repeated testing cycles to ensure alignment with real world practice.

Results: Co development led to marked improvements in usability, workflow clarity, and operational safety. Clinicians reported greater confidence navigating the tool, with dashboards reducing pathway ambiguity and conditional logic preventing incorrect data entry. Automated survey invitations improved timeliness and reduced administrative burden. PPI feedback directly shaped clearer, more accessible patient facing materials. Overall, the tool evolved from a static eCRF copy into a dynamic system aligned with real world primary care practice.

Conclusion: Collaborative co development with clinicians and patients was essential to transforming the data collection tool into a functional, intuitive, and workflow aligned platform for PGx implementation. This work demonstrates the value of iterative, user centred design in developing digital infrastructure for personalised prescribing across the UK and Ireland, offering a replicable model for future implementation efforts.