Trial reportBMC family practice2015
Exposure to and experiences with a computerized decision support intervention in primary care: results from a process evaluation.
Trial report in BMC family practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01773057 (Effects of the Computerized Decision Support System 'NHGDoc' on Quality of Care), which is not on this map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of the Computerized Decision Support System 'NHGDoc' on Quality of Care: a Cluster Randomized Controlled Trial
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Exploring the role of professional identity in the implementation of clinical decision support systems-a narrative review.Implementation science : IS · 2024Pooled it
- Barriers and Facilitators to the Use of Clinical Decision Support Systems in Primary Care: A Mixed-Methods Systematic Review.Annals of family medicinePooled it
- Trial
- Computer-Based Driving in Dementia Decision Tool With Mail Support: Cluster Randomized Controlled Trial.Journal of medical Internet research · 2018Trial
- Process evaluation of a tailored intervention programme of cardiovascular risk management in general practices.Implementation science : IS · 2016Trial
- Applying the Non-Adoption, Abandonment, Scale-up, Spread, and Sustainability Framework Across Implementation Stages to Identify Key Strategies to Facilitate Clinical Decision Support System Integration Within a Large Metropolitan Health Service: Interview and Focus Group Study.JMIR medical informatics · 2024Article
- Barriers to and Facilitators of Key Stakeholders Influencing Successful Digital Implementation of Remote Monitoring Solutions: Mixed Methods Analysis.JMIR human factors · 2024Article
- Improving computerized decision support system interventions: a qualitative study combining the theoretical domains framework with the GUIDES Checklist.BMC medical informatics and decision making · 2023Article
- Workload and workflow implications associated with the use of electronic clinical decision support tools used by health professionals in general practice: a scoping review.BMC primary care · 2023Article
- Barriers and enablers to implementing and using clinical decision support systems for chronic diseases: a qualitative systematic review and meta-aggregation.Implementation science communications · 2022Review
- General practitioner and nurse practitioner attitudes towards electronic reminders in primary care: a qualitative analysis.BMJ open · 2021Article
- Factors That Impact the Adoption of Clinical Decision Support Systems (CDSS) for Antibiotic Management.International journal of environmental research and public health · 2021Article
- Article
- Article
- A system uptake analysis and GUIDES checklist evaluation of the Electronic Asthma Management System: A point-of-care computerized clinical decision support system.Journal of the American Medical Informatics Association : JAMIA · 2020Article
- Evaluating the Feasibility of a Software Prototype Supporting the Management of Multimorbid Seniors: Mixed Methods Study in General Practices.JMIR human factors · 2019Article
- The GUIDES checklist: development of a tool to improve the successful use of guideline-based computerised clinical decision support.Implementation science : IS · 2018Article
- Use of electronic medical records and biomarkers to manage risk and resource efficiencies.European clinical respiratory journal · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrials evaluating the effects of interventions usually provide little insight into the factors responsible for (lack of) changes in desired outcomes. A process evaluation alongside a trial can shed light on the mechanisms responsible for the outcomes of a trial. The aim of this study was to investigate exposure to and experiences with a computerized decision support system (CDSS) intervention, in order to gain insight into the intervention's impact and to provide suggestions for improvement.
methodsA process evaluation was conducted as part of a large-scale cluster-randomized controlled trial investigating the effects of the CDSS NHGDoc on quality of care. Data on exposure to and experiences with the intervention were collected during the trial period among participants in both the intervention and control group - whenever applicable - by means of the NHGDoc server and an electronic questionnaire. Multiple data were analyzed using descriptive statistics.
resultsNinety-nine percent (n = 229) of the included practices generated data for the NHGDoc server and 50 % (n = 116) responded to the questionnaire: both general practitioners (GPs; n = 112; 49 %) and practice nurses (PNs; n = 52; 37 %) participated. The actual exposure to the NHGDoc system and specific heart failure module was limited with 52 % of the GPs and 42 % of the PNs reporting to either never or rarely use the system. Overall, users had a positive attitude towards CDSSs. The most perceived barriers to using NHGDoc were a lack of learning capacity of the system, the additional time and work it requires to use the CDSS, irrelevant alerts, too high intensity of alerts and insufficient knowledge regarding the system.
conclusionsSeveral types of barriers may have negatively affected the impact of the intervention. Although users are generally positive about CDSSs, a large share of them is insufficiently aware of the functions of NHGDoc and, finds the decision support not always useful or relevant and difficult to integrate into daily practice. In designing CDSS interventions we suggest to more intensely involve the end-users and increase the system's flexibility and learning capacity. To improve implementation a proper introduction of a CDSS among its target group including adequate training is advocated.
trial registrationClinical trials NCT01773057 .
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.