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.
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.
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。