SynthesisAnnals of family medicine
Barriers and Facilitators to the Use of Clinical Decision Support Systems in Primary Care: A Mixed-Methods Systematic Review.
Synthesis in Annals of family medicine. 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 90 papers, 7 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
90 citing papers in PubMed, 7 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- 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
- Why aren't they used? Systematic review of barriers to implementation of clinical decision support systems for early cancer detection in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 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
- Are Canadian Clinical Practice Guidelines Accounting for Adults With Multiple Chronic Diseases? A Systematic Review.Journal of evaluation in clinical practice · 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
- Patterns of CDSS adoption in primary care: a cluster analysis and predictive modelling study from a stepped wedge trial.Implementation science : IS · 2026Trial
- Effect of an electronic health record-integrated machine learning asthma risk marker on pediatrician prognostic accuracy during preschool age: a pilot randomized clinical trial.Scientific reports · 2026Trial
- Clinical Decision Support System, Antihypertensive Treatment Intensification, and Blood Pressure Control: A Post Hoc Secondary Analysis of a Cluster Randomized Trial.JAMA network open · 2026Trial
- Exposure to clinical decision support and training increases primary care clinician confidence in managing cognitive impairment care but not confidence to diagnose.BMC primary care · 2025Trial
- Learning from Misses: Evaluating a Clinical Decision Support for Chronic Pain Management in Primary Care.Applied clinical informatics · 2025Trial
- User Actions within a Clinical Decision Support Alert for the Management of Hypertension in Chronic Kidney Disease.Applied clinical informatics · 2025Trial
- Integrating Artificial Intelligence in Nursing Practice With Decubitus Risk Prediction Alerts: A Pilot Process Evaluation.Journal of clinical nursing · 2026Article
- Patient-Centered Clinical Decision Support for Recommended Screenings in French Primary Care: Protocol for a Multicenter Mixed Methods Feasibility Study.JMIR research protocols · 2026Article
- Exploring primary care providers' perspectives on clinical decision support for venous thromboembolism diagnosis: a qualitative study.BMJ open · 2026Article
- 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
- Prospective evaluation of a large language model clinical decision support system in the emergency department.Nature medicine · 2026Article
- Factors associated with chronic pain clinical decision support use in primary care.PLOS digital health · 2026Article
- Factors Influencing Physician Adherence to Venous Thromboembolism Risk Assessment Model Recommendations: A Best-Worst Scaling.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Article
30 more citing papers are in PubMed but not listed here.
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 at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo identify and quantify the barriers and facilitators to the use of clinical decision support systems (CDSSs) by primary care professionals (PCPs).
methodsA mixed-methods systematic review was conducted using a sequential synthesis design. PubMed/MEDLINE, PsycInfo, Embase, CINAHL, and the Cochrane library were searched in July 2021. Studies that evaluated CDSSs providing recommendations to PCPs and intended for use during a consultation were included. We excluded CDSSs used only by patients, described as concepts or prototypes, used with simulated cases, and decision supports not considered as CDSSs. A framework synthesis was performed according to the HOT-fit framework (Human, Organizational, Technology, Net Benefits), then a quantitative synthesis evaluated the impact of the HOT-fit categories on CDSS use.
resultsA total of 48 studies evaluating 45 CDSSs were included, and 186 main barriers or facilitators were identified. Qualitatively, barriers and facilitators were classified as human (eg, perceived usefulness), organizational (eg, disruption of usual workflow), and technological (eg, CDSS user-friendliness), with explanatory elements. The greatest barrier to using CDSSs was an increased workload. Quantitatively, the human and organizational factors had negative impacts on CDSS use, whereas the technological factor had a neutral impact and the net benefits dimension a positive impact.
conclusionsOur findings emphasize the need for CDSS developers to better address human and organizational issues, in addition to technological challenges. We inferred core CDSS features covering these 3 factors, expected to improve their usability in primary care.
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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.