关于老年人慢性疼痛管理和临床决策支持的初级保健临床医生观点:定性研究
Isra Hasnain1, Erin M Staab2, Ainur Kagarmanova2
1Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States.
JMIR formative research
|September 16, 2025
概括
初级保健临床医生发现I-COPE临床决策支持系统 (CDSS) 有助于老年人治疗慢性疼痛. 虽然有利于以患者为中心的护理,但工作流集成和工具复杂性的挑战需要进一步改进.
科学领域:
- 老年病的医生 老年病的医生
- 初级医疗保健医学 一级医疗保健医学
- 医疗信息学 医疗信息学
背景情况:
- 老年人的慢性疼痛管理对初级保健临床医生来说具有独特的挑战,包括并发症,副作用和复杂的指导方针.
- 临床决策支持系统 (CDSS) 通过整合指南,患者数据和共享决策来提供潜在的解决方案.
- I-COPE (通过以患者为中心的临床决策支持和ECHO项目改善芝加哥老年人阿片类药物和疼痛管理) 是一个基于EHR的CDSS,旨在达到这一目的.
研究的目的:
- 检查初级保健医生对慢性疼痛管理挑战的看法.
- 评估临床医生对I-COPE CDSS的意见和经验.
主要方法:
- 与18名初级保健临床医生 (医生和高级实践护士) 进行了半结构化采访,试验I-COPE CDSS.
- 采访指南以实施研究综合框架为基础,探讨当前的实践,挑战和对I-COPE工具的反.
主要成果:
- 临床医生强调了以患者为中心,多模式和非药物治疗的慢性疼痛管理方法.
- 确定的障碍包括并发症,有限的访问时间,保险问题和阿片类药物滥用问题.
- I-COPE CDSS被视为对标准化护理讨论,提高效率,引出患者目标和促进共享决策有益,尽管注意到了对复杂性和工作流集成的担忧.
结论:
- I-COPE CDSS在支持基于指导方针的,以患者为中心的慢性疼痛和阿片类药物管理方面显示出前途.
- 为了成功实施,建议进一步改进可用性,适应工作流程的适应性和公平访问.
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