Clinical Decision Support Systems for Palliative Care Management: A Scoping Review

Area of Science:

• Palliative Care
• Health Informatics
• Clinical Decision Support

Background:

• Palliative care services are expanding in clinical settings.
• Clinical decision support systems (CDSSs) are vital for enhancing care quality for patients with life-limiting conditions.
• Nurses and clinicians require effective tools to support complex patient care decisions.

Purpose of the Study:

• To characterize palliative care CDSSs.
• To explore end-users' actions, adherence to recommendations, and clinical decision time.
• To identify factors influencing the effectiveness and usability of palliative care CDSSs.

Main Methods:

• Systematic scoping review of CINAHL, Embase, and PubMed databases (inception–September 2022).
• Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.
• Analysis of 12 selected studies from 284 screened abstracts, assessing evidence levels.

Main Results:

• Palliative care CDSSs focus on patient identification, referrals, medication, and symptom management.
• All studies indicated CDSSs improved clinician knowledge, leading to better decisions and patient outcomes.
• Adherence to CDSS recommendations varied (3 high, 4 low), with usability issues like lack of customization and trust cited as limitations.

Conclusions:

• Palliative care CDSSs can improve care quality for patients.
• Variability in CDSSs and study methods complicates direct comparisons of effectiveness.
• Further research with rigorous methods is recommended to evaluate CDSS features, adherence, and efficiency.