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本文引用的文献

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HIV Preexposure Prophylaxis Provision among Adolescents: 2018 to 2021.青少年中的 HIV 暴露前预防措施提供情况：2018 年至 2021 年。
Pediatrics. 2023 Nov 1;152(5). doi: 10.1542/peds.2023-062599.
2
Preexposure Prophylaxis to Prevent Acquisition of HIV: US Preventive Services Task Force Recommendation Statement.暴露前预防（PrEP）以预防 HIV 感染：美国预防服务工作组推荐声明。
JAMA. 2023 Aug 22;330(8):736-745. doi: 10.1001/jama.2023.14461.
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Provider perspectives on clinical decision support to improve HIV prevention in pediatric primary care: a multiple methods study.医疗服务提供者对改善儿科初级保健中艾滋病预防的临床决策支持的看法：一项多方法研究。
Implement Sci Commun. 2023 Feb 21;4(1):18. doi: 10.1186/s43058-023-00394-7.
4
Usability and Utility of Human Immunodeficiency Virus Pre-exposure Prophylaxis Clinical Decision Support to Increase Knowledge and Pre-exposure Prophylaxis Initiations among Pediatric Providers.人类免疫缺陷病毒暴露前预防临床决策支持提高儿科医务人员知识和暴露前预防启动率的实用性和有效性。
Appl Clin Inform. 2022 Oct;13(5):1141-1150. doi: 10.1055/a-1975-4277. Epub 2022 Nov 9.
5
Pediatric Provider Utilization of a Clinical Decision Support Alert and Association with HIV Pre-exposure Prophylaxis Prescription Rates.儿科医务人员对临床决策支持警报的使用及其与 HIV 暴露前预防处方率的关联。
Appl Clin Inform. 2022 Jan;13(1):30-36. doi: 10.1055/s-0041-1740484. Epub 2022 Jan 12.
6
Adolescents and Young Adults: The Pediatrician's Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis.青少年和年轻人：儿科医生在 HIV 检测以及 HIV 暴露前和暴露后预防中的作用。
Pediatrics. 2022 Jan 1;149(1). doi: 10.1542/peds.2021-055207.
7
Provider Comfort with Prescribing HIV Pre-Exposure Prophylaxis to Adolescents.提供者对为青少年开具 HIV 暴露前预防药物的舒适度。
AIDS Patient Care STDS. 2021 Oct;35(10):411-417. doi: 10.1089/apc.2021.0045.
8
Applying Behavioral Economics to Improve Adolescent and Young Adult Health: A Developmentally-Sensitive Approach.应用行为经济学改善青少年和青年健康：一种发展敏感的方法。
J Adolesc Health. 2021 Jul;69(1):17-25. doi: 10.1016/j.jadohealth.2020.10.007. Epub 2020 Dec 4.
9
HIV Preexposure Prophylaxis Among Adolescents in the US: A Review.美国青少年中的 HIV 暴露前预防：综述。
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10
Adolescent Health Providers' Willingness to Prescribe Pre-Exposure Prophylaxis (PrEP) to Youth at Risk of HIV Infection in the United States.美国青少年健康提供者对有感染 HIV 风险的青少年开具暴露前预防（PrEP）药物的意愿。
J Adolesc Health. 2018 Aug;63(2):242-244. doi: 10.1016/j.jadohealth.2018.03.016. Epub 2018 May 26.

儿科医生对促进HIV暴露前预防的电子临床决策支持的偏好

Pediatrician Preferences for Electronic Clinical Decision Support to Facilitate HIV Pre-Exposure Prophylaxis.

作者信息

Guss Carly E, DeMaio Danielle, Gluskin Brittany, Daddario Salvatore, Addison Jessica, Fitzgerald Susan, Mayer Kenneth H, Wisk Lauren E, Krakower Douglas

机构信息

Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.

Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.

出版信息

J Adolesc Health. 2024 Aug;75(2):368-371. doi: 10.1016/j.jadohealth.2024.04.005. Epub 2024 Jun 8.

DOI:10.1016/j.jadohealth.2024.04.005
PMID:38852087
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11257793/
Abstract

PURPOSE

Pediatric primary care clinicians are often uncertain about patients' HIV infection risk and pre-exposure prophylaxis (PrEP) prescribing guidelines. This study was conducted to help identify ways to design and deliver useful electronic health record (EHR)-based alerts for PrEP to help mitigate this issue.

METHODS

Individual interviews and focus groups with pediatricians explored provider preferences for clinical decision support around PrEP in the EHR. Key themes were identified via the immersion-crystallization qualitative analytic technique.

RESULTS

Clinicians described ideal decision support tools as succinct, helpful in identifying patients at risk of acquiring HIV, providing automated follow-up, and linking to evidence-based prescribing guidelines. Concerns emerged about alert fatigue.

DISCUSSION

This study summarizes clinicians' preferences for EHR tool development to support PrEP provision among pediatricians with limited comfort and experience with prescribing PrEP. These findings can inform the development of PrEP decision support by implementing provider-centered feedback.

摘要

目的

儿科初级保健临床医生常常不确定患者的HIV感染风险及暴露前预防（PrEP）的处方指南。开展这项研究是为了帮助确定设计和提供基于电子健康记录（EHR）的PrEP实用警报的方法，以帮助缓解这一问题。

方法

对儿科医生进行个人访谈和焦点小组讨论，探讨医疗服务提供者对EHR中围绕PrEP的临床决策支持的偏好。通过沉浸-结晶定性分析技术确定关键主题。

结果

临床医生将理想的决策支持工具描述为简洁明了，有助于识别有感染HIV风险的患者，提供自动随访，并与循证处方指南相链接。对警报疲劳的担忧也随之出现。

讨论

本研究总结了临床医生对EHR工具开发的偏好，以支持在开具PrEP方面舒适度和经验有限的儿科医生提供PrEP。这些发现可为通过实施以医疗服务提供者为中心的反馈来开发PrEP决策支持提供参考。