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意大利支持多药治疗管理的工具:决定数字技术在临床实践中使用意愿的因素。

Tools supporting polypharmacy management in Italy: Factors determining digital technologies' intention to use in clinical practice.

作者信息

Catrini Elisabetta, Ferrario Lucrezia, Mazzone Antonino, Varalli Luca, Gatti Federico, Cannavacciuolo Lorella, Ponsiglione Cristina, Foglia Emanuela

机构信息

Centre for Health Economics, Social and Health Care Managament, LIUC Business School LIUC Università Cattaneo Castellanza Varese Italy.

Internal Medicine Department ASST Ovest Milanese Legnano Italy.

出版信息

Health Sci Rep. 2022 May 19;5(3):e647. doi: 10.1002/hsr2.647. eCollection 2022 May.

Abstract

BACKGROUND AND AIMS

INTERCheckWEB is one of the most outstanding digital technologies, that could be implemented at the hospital level, supporting the clinicians in the evaluation of the therapy appropriateness, reducing the potentially inappropriate prescriptions, for the improvement of the clinical decision-making process. The paper aims at investigating the relationship between clinicians' behaviors towards digital decision support system in therapy appropriateness for elderly patients in polytherapy in medical departments, defining the factors that could influence clinicians to use INTERCheckWEB, for supporting drugs' prescription.

METHODS

A questionnaire was administered to 70 clinicians referring to Internal Medicine wards, of four Italian hospitals. The authors assessed how perceived usefulness, perceived ease of use, image, and output quality, would affect INTERCheckWeb intention to use. Inferential statistics, by means of a regression analysis, were conducted to define the main aspects useful to understand the factors impacting on such digital technology adoption in clinical practice.

RESULTS

The regression analysis reported that image, perceived ease of use and perceived usefulness, as well as the moderator effect of the voluntary use between the perceived usefulness and the intention to use, are the factors that most influence the use of INTERCheckWEB (adjusted  = 0.870).

CONCLUSIONS

Results demonstrated that clinicians would use INTERCheckWEB, when available, to identify all the information on situations that could be dangerous for the patients, thus limiting the drug-drug interactions, optimizing the overall patient's clinical pathway. Furthermore, the implementation of INTERCheckWEB could also contribute to the proper management of COVID-19 patients, since both hospitalized and symptomatic COVID-19 patients are frequently older, with comorbidities.

摘要

背景与目的

INTERCheckWEB是最杰出的数字技术之一,可在医院层面实施,支持临床医生评估治疗的适宜性,减少潜在的不适当处方,以改善临床决策过程。本文旨在调查内科病房临床医生在老年患者多药治疗中对数字决策支持系统的行为与治疗适宜性之间的关系,确定可能影响临床医生使用INTERCheckWEB以辅助药物处方的因素。

方法

对意大利四家医院内科病房的70名临床医生进行了问卷调查。作者评估了感知有用性、感知易用性、形象和输出质量如何影响使用INTERCheckWeb的意愿。通过回归分析进行推断统计,以确定有助于理解影响临床实践中采用这种数字技术的因素的主要方面。

结果

回归分析表明,形象、感知易用性和感知有用性,以及感知有用性与使用意愿之间的自愿使用调节效应,是最影响INTERCheckWEB使用的因素(调整后 = 0.870)。

结论

结果表明,临床医生在有条件时会使用INTERCheckWEB来识别所有可能对患者有危险的情况的信息,从而限制药物相互作用,优化患者的整体临床路径。此外,INTERCheckWEB的实施也有助于对COVID-19患者进行适当管理,因为住院的和有症状的COVID-19患者通常年龄较大且伴有合并症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec89/9117970/a27bceab6449/HSR2-5-e647-g001.jpg

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