ReviewImplementation science communications2022
Barriers and enablers to implementing and using clinical decision support systems for chronic diseases: a qualitative systematic review and meta-aggregation.
Review in Implementation science communications, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07398235 (A Qualitative Study to Explore the Barriers to Adoption of Clinical Decision Support Systems), which is not on this map. Cited by 38 papers, 6 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.
A Qualitative Study to Explore the Barriers to Adoption of Clinical Decision Support Systems
Who cites it
38 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- The Impact of Digitalization on European General Practice From the Perspective of General Practitioners: Systematic Review.Journal of medical Internet research · 2026Pooled it
- Barriers and facilitators to the implementation and adoption of computerised clinical decision support systems: an overview of reviews.Systematic reviews · 2026Pooled it
- Enabling digital multifactorial risk assessment in primary care: an umbrella review and recommendations for design and implementation.BMJ health & care informatics · 2026Pooled it
- The implementation challenge of computerised clinical decision support systems for the detection of disease in primary care: systematic review and recommendations.Implementation science : IS · 2025Pooled it
- Understanding "Alert Fatigue" in Primary Care: Qualitative Systematic Review of General Practitioners Attitudes and Experiences of Clinical Alerts, Prompts, and Reminders.Journal of medical Internet research · 2025Pooled it
- Health Care Professionals' Experience of Using AI: Systematic Review With Narrative Synthesis.Journal of medical Internet research · 2024Pooled it
- Patterns of CDSS adoption in primary care: a cluster analysis and predictive modelling study from a stepped wedge trial.Implementation science : IS · 2026Trial
- Influence of a clinical decision support system on the anticoagulation treatment knowledge, attitude and practice of general practitioners and their using experience: a mixed method study.BMC primary care · 2026Trial
- The GUIDE-CDSS framework: a comprehensive framework to GUIDE and evaluate the implementation of Clinical Decision Support Systems in healthcare, based on an overview of reviews.Journal of the American Medical Informatics Association : JAMIA · 2026Review
- Article
- Factors associated with chronic pain clinical decision support use in primary care.PLOS digital health · 2026Article
- A Systematic Review of Factors Affecting Utilization of Decision Support Systems: The Interplay Between Technology, Users, and the Healthcare Environment.Health science reports · 2026Review
- From Concept to Practice: Lessons From the Balanced Nursing Teams Decision-Support System.JMIR nursing · 2026Article
- Impact of WHO AWaRe Antibiotic Handbook training on antibiotics prescribing knowledge among private primary care providers: a vignette-based, prep-post pilot study in Patna, India.Antimicrobial resistance and infection control · 2026Article
- Article
- Facilitators, barriers, and insights using an HFA-PEFF-based clinical decision support system: A proof-of-concept study.ESC heart failure · 2025Article
- Exploring barriers and facilitators for the potential implementation of the decision tool-functional independence in primary care.BMC health services research · 2025Article
- Controversy in Hypertension: Pro-Side of the Argument Using Artificial Intelligence for Hypertension Diagnosis and Management.Hypertension (Dallas, Tex. : 1979) · 2025Review
- Personalized Digital Care Pathways Enable Enhanced Patient Management as Perceived by Health Care Professionals: Mixed-Methods Study.JMIR human factors · 2025Article
- Digital Decision Support for Perioperative Care of Patients With Type 2 Diabetes: A Call to Action.JMIR diabetes · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundClinical decision support (CDS) is increasingly used to facilitate chronic disease care. Despite increased availability of electronic health records and the ongoing development of new CDS technologies, uptake of CDS into routine clinical settings is inconsistent. This qualitative systematic review seeks to synthesise healthcare provider experiences of CDS-exploring the barriers and enablers to implementing, using, evaluating, and sustaining chronic disease CDS systems.
methodsA search was conducted in Medline, CINAHL, APA PsychInfo, EconLit, and Web of Science from 2011 to 2021. Primary research studies incorporating qualitative findings were included if they targeted healthcare providers and studied a relevant chronic disease CDS intervention. Relevant CDS interventions were electronic health record-based and addressed one or more of the following chronic diseases: cardiovascular disease, diabetes, chronic kidney disease, hypertension, and hypercholesterolaemia. Qualitative findings were synthesised using a meta-aggregative approach.
resultsThirty-three primary research articles were included in this qualitative systematic review. Meta-aggregation of qualitative data revealed 177 findings and 29 categories, which were aggregated into 8 synthesised findings. The synthesised findings related to clinical context, user, external context, and technical factors affecting CDS uptake. Key barriers to uptake included CDS systems that were simplistic, had limited clinical applicability in multimorbidity, and integrated poorly into existing workflows. Enablers to successful CDS interventions included perceived usefulness in providing relevant clinical knowledge and structured chronic disease care; user confidence gained through training and post training follow-up; external contexts comprised of strong clinical champions, allocated personnel, and technical support; and CDS technical features that are both highly functional, and attractive.
conclusionThis systematic review explored healthcare provider experiences, focussing on barriers and enablers to CDS use for chronic diseases. The results provide an evidence-base for designing, implementing, and sustaining future CDS systems. Based on the findings from this review, we highlight actionable steps for practice and future research.
trial registrationPROSPERO CRD42020203716.
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Identifiers
What OpenQuestion holds
Registered trials
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.