Evidence map›Paper›PMID 39535290›Full record

ArticleJMIR human factors2024

Clinical Acceptability of a Quality Improvement Program for Reducing Cardiovascular Disease Risk in People With Chronic Kidney Disease in Australian General Practice: Qualitative Study.

Caroline McBride, Barbara Hunter, Natalie Lumsden, Kaleswari Somasundaram, Rita McMorrow, Douglas Boyle, Jon Emery, Craig Nelson, Jo-Anne Manski-Nankervis

Abstract read
In one paragraph

Article in JMIR human factors, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Caroline McBrideDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Australia.ORCID 0000-0002-8273-3894
Barbara HunterDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Australia.ORCID 0000-0002-1268-3166
Natalie LumsdenDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Australia.ORCID 0000-0002-7471-2487
Kaleswari SomasundaramDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Australia.ORCID 0000-0002-4330-3453
Rita McMorrowDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Australia.ORCID 0000-0002-2835-9504
Douglas BoyleDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Australia.ORCID 0000-0002-4779-7083
Jon EmeryDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Australia.ORCID 0000-0002-5274-6336
Craig NelsonWestern Health Chronic Disease Alliance, Western Health, Sunshine, Australia.ORCID 0000-0003-3548-4167
Jo-Anne Manski-NankervisDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Australia.ORCID 0000-0003-2153-3482

Funding

Cancer Research UK C8640/A23385
6 · The paper itself

Abstract

Background: Future Health Today (FHT) is a technology program that integrates with general practice clinical software to provide point of care (PoC) clinical decision support and a quality improvement dashboard. This qualitative study looks at the use of FHT in the context of cardiovascular disease risk in chronic kidney disease (CKD). Objective: This study aims to explore factors influencing clinical implementation of the FHT module focusing on cardiovascular risk in CKD, from the perspectives of participating general practitioner staff. Methods: Practices in Victoria were recruited to participate in a pragmatic cluster randomized controlled trial using FHT, of which 19 practices were randomly assigned to use FHT's cardiovascular risk in CKD program. A total of 13 semistructured interviews were undertaken with a nominated general practitioner (n=7) or practice nurse (n=6) from 10 participating practices. Interview questions focused on the clinical usefulness of the tool and its place in clinical workflows. Qualitative data were coded by 2 researchers and analyzed using framework analysis and Clinical Performance Feedback Intervention Theory. Results: All 13 interviewees had used the FHT PoC tool, and feedback was largely positive. Overall, clinicians described engaging with the tool as a "prompt" or "reminder" system. Themes reflected that the tool's goals and clinical content were aligned with clinician's existing priorities and knowledge, and the tool's design facilitated easy integration into existing workflows. The main barrier to implementation identified by 2 clinicians was notification fatigue. A total of 7 interviewees had used the FHT dashboard tool. The main barriers to use were its limited integration into clinical workflows, such that some participants did not know of its existence; clinicians' competing clinical priorities; and limited time to learn and use the tool. Conclusions: This study identified many facilitators for the successful use of the FHT PoC program, in the context of cardiovascular risk in CKD, and barriers to the use of the dashboard program. This work will be used to inform the wider implementation of FHT, as well as the development of future modules of FHT for other risk or disease states.

Indexed as

Cardiovascular DiseasesGeneral PracticeQualitative ResearchQuality ImprovementRenal Insufficiency, ChronicDecision Support Systems, ClinicalFemaleHumansMaleMiddle AgedVictoriacardiologycardiovascular riskchronic diseasechronic kidney diseaseCKDclinical decision supportclinical softwareEHRelectronic health recordfamily medicinefamily physiciangeneral medicinegeneral practiceGPimplementation sciencenephrologistnephrologyprimary carequality improvement

Identifiers

PMID39535290
PMCPMC11577681

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.