Optimising a clinical decision support tool to improve chronic kidney disease management in general practice

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dc.article.number220
dc.catalogadoryvc
dc.contributor.authorHunter, Barbara
dc.contributor.authorDavidson, Sandra
dc.contributor.authorLumsden, Natalie
dc.contributor.authorChima, Sophie
dc.contributor.authorMartínez Gutiérrez, Javiera
dc.contributor.authorEmery, Jon
dc.contributor.authorNelson, Craig
dc.contributor.authorManski-Nankervis, Jo-Anne
dc.date.accessioned2024-06-24T21:52:27Z
dc.date.available2024-06-24T21:52:27Z
dc.date.issued2024
dc.date.updated2024-06-23T00:03:38Z
dc.description.abstractEarly identification and treatment of chronic disease is associated with better clinical outcomes, lower costs, and reduced hospitalisation. Primary care is ideally placed to identify patients at risk of, or in the early stages of, chronic disease and to implement prevention and early intervention measures. This paper evaluates the implementation of a technological intervention called Future Health Today that integrates with general practice EMRs to (1) identify patients at-risk of, or with undiagnosed or untreated, chronic kidney disease (CKD), and (2) provide guideline concordant recommendations for patient care. The evaluation aimed to identify the barriers and facilitators to successful implementation. Methods Future Health Today was implemented in 12 general practices in Victoria, Australia. Fifty-two interviews with 30 practice staff were undertaken between July 2020 and April 2021. Practice characteristics were collected directly from practices via survey. Data were analysed using inductive and deductive qualitative analysis strategies, using Clinical Performance - Feedback Intervention Theory (CP-FIT) for theoretical guidance. Results Future Health Today was acceptable, user friendly and useful to general practice staff, and supported clinical performance improvement in the identification and management of chronic kidney disease. CP-FIT variables supporting use of FHT included the simplicity of design and delivery of actionable feedback via FHT, good fit within existing workflow, strong engagement with practices and positive attitudes toward FHT. Context variables provided the main barriers to use and were largely situated in the external context of practices (including pressures arising from the COVID-19 pandemic) and technical glitches impacting installation and early use. Participants primarily utilised the point of care prompt rather than the patient management dashboard due to its continued presence, and immediacy and relevance of the recommendations on the prompt, suggesting mechanisms of compatibility, complexity, actionability and credibility influenced use. Most practices continued using FHT after the evaluation phase was complete. Conclusions This study demonstrates that FHT is a useful and acceptable software platform that provides direct support to general practice in identifying and managing patients with CKD. Further research is underway to explore the effectiveness of FHT, and to expand the conditions on the platform.
dc.fechaingreso.objetodigital2024-06-23
dc.format.extent14 páginas
dc.fuente.origenBiomed Central
dc.identifier.citationBMC Primary Care. 2024 Jun 19;25(1):220
dc.identifier.urihttps://doi.org/10.1186/s12875-024-02470-w
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/86838
dc.information.autorucEscuela de Medicina;Martínez Gutiérrez, Javiera;0000-0002-2493-9974;18421
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaBMC Primary Care
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseCC BY Attribution International 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectChronic disease
dc.subjectChronic kidney disease
dc.subjectCardiovascular
dc.subjectGeneral practice
dc.subjectPrimary care
dc.subjectPatient care
dc.subjectHealth technology
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleOptimising a clinical decision support tool to improve chronic kidney disease management in general practice
dc.typeartículo
dc.volumen25
sipa.codpersvinculados18421
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