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临床决策支持系统对从事肌肉骨骼健康工作的首诊医生(FCPs)有帮助吗?

Are clinical decision support systems seen as helpful to First Contact Practitioners (FCPs) working in musculoskeletal health?

作者信息

Salt Emma, Khalid Mo, Van Der Windt Danielle, Hill Jonathan

机构信息

University Hospitals of Derby and Burton NHS Foundation Trust, Staffordshire DE13 0RB, United Kingdom; Versus Arthritis Primary Care Centre, School of Medicine, Keele, Staffordshire ST5 5BG, United Kingdom.

University Hospitals of Derby and Burton NHS Foundation Trust, Staffordshire ST13 0RB, United Kingdom.

出版信息

Physiotherapy. 2025 Mar;126:101445. doi: 10.1016/j.physio.2024.101445. Epub 2024 Oct 29.

Abstract

BACKGROUND

There is increasing burden on musculoskeletal (MSK) First Contact Practitioners (FCPs) working in primary care. One possible solution is to use digital technologies such as clinical decision support systems (CDSS). The primary objective of this study was to understand the potential for MSK FCPs to use a CDSS to support their practice in the United Kingdom.

DESIGN

An exploratory sequential mixed methods design, using a cross sectional survey questionnaire and a subsequent focus group. Following ethical approval responders were recruited via professional networks to complete an online survey. A subsequent focus group enabled an in-depth exploration of survey results. Descriptive statistics were used to summarise survey data and thematic analysis with normalisation process theory used to describe findings.

METHODS

A snowball sampling method was used to invite MSK FCPs to complete the survey, using email, adverts and social media. The questionnaire captured responders' demographic and professional practice characteristics, their knowledge and use of CDSS and their views and experiences regarding CDSS in MSK practice.

RESULTS

There were 75 responders to the survey and six participants in the focus group. The majority of responders 67% (n = 50/75) reported to be in favour of integrating a CDSS into their practice. Three themes were: 1) ensuring CDSS address efficiency concerns, 2) using CDSS to reduce unwarranted variation in practice, and 3) ensuring CDSS sustainability.

CONCLUSIONS

CDSSs have potential value for FCPs working in MSK primary care settings. Eight summary recommendations advise future developments of CDSS for FCPs working in MSK primary care practice. CONTRIBUTION OF THE PAPER.

摘要

背景

在基层医疗工作的肌肉骨骼(MSK)首诊医生(FCP)面临的负担日益加重。一种可能的解决方案是使用临床决策支持系统(CDSS)等数字技术。本研究的主要目的是了解MSK FCP在英国使用CDSS来支持其临床实践的潜力。

设计

采用探索性序列混合方法设计,使用横断面调查问卷和随后的焦点小组。在获得伦理批准后,通过专业网络招募受访者以完成在线调查。随后的焦点小组对调查结果进行了深入探讨。使用描述性统计来总结调查数据,并运用规范化过程理论进行主题分析以描述研究结果。

方法

采用滚雪球抽样方法,通过电子邮件、广告和社交媒体邀请MSK FCP完成调查。问卷收集了受访者的人口统计学和专业实践特征、他们对CDSS的了解和使用情况,以及他们对MSK实践中CDSS的看法和经验。

结果

调查有75名受访者,焦点小组有6名参与者。大多数受访者67%(n = 50/75)表示赞成在其临床实践中整合CDSS。三个主题分别是:1)确保CDSS解决效率问题,2)使用CDSS减少实践中不必要的差异,3)确保CDSS的可持续性。

结论

CDSS对在MSK基层医疗环境中工作的FCP具有潜在价值。八项总结建议为在MSK基层医疗实践中工作的FCP的CDSS未来发展提供了建议。论文的贡献。

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