Mogharbel Asra, Dowding Dawn, Ainsworth John
Division of Informatics Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Centre for Health Informatics, The University of Manchester, Manchester, United Kingdom.
Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
JMIR Med Inform. 2021 Mar 4;9(3):e22923. doi: 10.2196/22923.
Computerized physician order entry (CPOE) systems in health care settings have many benefits for prescribing medication, such as improved quality of patient care and patient safety. However, to achieve their full potential, the factors influencing the usage of CPOE systems by physicians must be identified and understood.
The aim of this study is to identify the factors influencing the usage of CPOE systems by physicians for medication prescribing in their clinical practice.
We conducted a systematic search of the literature on this topic using four databases: PubMed, CINAHL, Ovid MEDLINE, and Embase. Searches were performed from September 2019 to December 2019. The retrieved papers were screened by examining the titles and abstracts of relevant studies; two reviewers screened the full text of potentially relevant papers for inclusion in the review. Qualitative, quantitative, and mixed methods studies with the aim of conducting assessments or investigations of factors influencing the use of CPOE for medication prescribing among physicians were included. The identified factors were grouped based on constructs from two models: the unified theory of acceptance and use of technology model and the Delone and McLean Information System Success Model. We used the Mixed Method Appraisal Tool to assess the quality of the included studies and narrative synthesis to report the results.
A total of 11 articles were included in the review, and 37 factors related to the usage of CPOE systems were identified as the factors influencing how physicians used CPOE for medication prescribing. These factors represented three main themes: individual, technological, and organizational.
This study identified the common factors that influenced the usage of CPOE systems by physicians for medication prescribing regardless of the type of setting or the duration of the use of a system by participants. Our findings can be used to inform implementation and support the usage of the CPOE system by physicians.
医疗保健机构中的计算机化医师医嘱录入（CPOE）系统在药物处方开具方面有诸多益处，例如提高患者护理质量和患者安全。然而，要充分发挥其潜力，必须识别并理解影响医师使用CPOE系统的因素。
本研究旨在识别影响医师在临床实践中使用CPOE系统进行药物处方开具的因素。
我们使用四个数据库（PubMed、CINAHL、Ovid MEDLINE和Embase）对该主题的文献进行了系统检索。检索时间为2019年9月至2019年12月。通过检查相关研究的标题和摘要对检索到的论文进行筛选；两名评审员对可能相关论文的全文进行筛选以纳入综述。纳入旨在评估或调查影响医师使用CPOE进行药物处方开具的因素的定性、定量和混合方法研究。根据两个模型（技术接受与使用统一理论模型和德洛内与麦克林信息系统成功模型）的结构对识别出的因素进行分组。我们使用混合方法评估工具评估纳入研究的质量，并采用叙述性综合法报告结果。
综述共纳入11篇文章，识别出37个与CPOE系统使用相关的因素，这些因素影响医师使用CPOE进行药物处方开具的方式。这些因素代表三个主要主题：个人、技术和组织。
本研究识别出了影响医师使用CPOE系统进行药物处方开具的常见因素，无论环境类型或参与者使用系统的时长如何。我们的研究结果可用于为CPOE系统的实施提供信息并支持医师对该系统的使用。
