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Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey
KJ. Ploegmakers, S. Medlock, AJ. Linn, Y. Lin, LJ. Seppälä, M. Petrovic, E. Topinkova, J. Ryg, MAC. Mora, F. Landi, H. Thaler, K. Szczerbińska, S. Hartikainen, G. Bahat, B. Ilhan, Y. Morrissey, T. Masud, N. van der Velde, JCM. van Weert, European...
Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články, práce podpořená grantem
- MeSH
- lékaři * MeSH
- lidé MeSH
- náchylnost k nemoci MeSH
- průzkumy a dotazníky MeSH
- řízení rizik MeSH
- senioři MeSH
- systémy pro podporu klinického rozhodování * MeSH
- úrazy pádem prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE: Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. METHODS: We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. RESULTS: We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. CONCLUSION: When designing a CDSS for Geriatric Medicine, the patient's medical complexity must be addressed whilst maintaining the doctor's decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients.
Amsterdam School of Communication Research ASCoR University of Amsterdam Amsterdam The Netherlands
Department of Geriatric Medicine Odense University Hospital Odense Denmark
Department of Internal Medicine and Paediatrics Ghent University Ghent Belgium
Faculty of Health and Social Sciences South Bohemian University Ceske Budejovice Czech Republic
Health Care of Older People East Kent Hospitals University NHS Foundation Trust Canterbury Kent UK
Nottingham University Hospitals NHS Trust Nottingham UK
School of Pharmacy University of Eastern Finland Kuopio Finland
Servicio de Geriatría Hospital General Universitario de Ciudad Real Ciudad Real Spain
Trauma Center Wien Meidling Kundratstrasse 37 1120 Vienna Austria
Citace poskytuje Crossref.org
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