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在初级保健中使用阿片类药物使用障碍临床决策支持工具的障碍和促进者
Stephanie A Hooker1, Leif I Solberg2, Kathleen M Miley2
1From the HealthPartners Institute, Research and Evaluation Division, Minneapolis, MN (SAH, LIM, KMM, CMB, RCR). stephanie.a.hooker@healthpartners.com.
初级保健临床医生面临使用阿片类药物使用障碍 (OUD) 临床决策支持 (CDS) 工具的障碍. 解决临床医生的兴趣,工作流集成和工具设计对于有效的OUD护理实施至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
- 成 药物 药物 药物 药物
背景情况:
- 临床决策支持 (CDS) 工具旨在将基于证据的指导方针纳入临床工作流程.
- 在初级保健中,CDS对阿片类药物使用障碍 (OUD) 管理的有效性取决于临床医生的采用.
- 了解临床医生和领导者的观点对于成功实施OUD-CDS工具至关重要.
研究的目的:
- 探索初级保健临床医生 (PCC) 和临床领导者对使用OUD-CDS工具的障碍和促进者的看法.
- 确定影响OUD-CDS工具在日常初级保健实践中的整合因素.
主要方法:
- 与13个PCC和诊所负责人进行了半结构化的定性访谈.
- 使用诱导性主题分析来确定与OUD-CDS工具实施相关的关键主题.
- 采访的重点是CDS工具的设计,实施,背景和内容作为潜在的障碍或促进者.
主要成果:
- 临床医生表示不愿讨论OUD,尽管对相关主题的CDS工具感兴趣.
- 在初级保健机构中的上下文因素对OUD-CDS工具的使用构成重大障碍.
- 有效的CDS的关键设计元素包括简单性,可见性,时间效率和临床附加值.
- CDS工具在患者识别,查和OUD转诊便利方面显示出潜在的价值.
结论:
- PCC对治疗OUD的兴趣,上下文限制和CDS工具设计显著影响了采用.
- 结果为优化OUD-CDS工具在初级保健机构中的实施提供了洞察力.
- 解决已识别的障碍可以提高CDS工具的实用性,以改善OUD在初级保健中的护理.
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