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交互式仪表板优化初级保健处方的有效性:一项系统评价方案

Effectiveness of interactive dashboards to optimise prescribing in primary care: a protocol for a systematic review.

作者信息

Moynagh Patrick, Mannion Áine, Wei Ashley, Clyne Barbara, Moriarty Frank, McCarthy Caroline

机构信息

Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland.

Department of Public Health & Epidemiology, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland.

出版信息

HRB Open Res. 2025 Feb 19;7:44. doi: 10.12688/hrbopenres.13909.1. eCollection 2024.

Abstract

INTRODUCTION

Advances in therapeutics and healthcare have led to a growing population of individuals living with multimorbidity and polypharmacy making prescribing more challenging. Most prescribing occurs in primary care and General Practitioners (GPs) have expressed interest in comparative feedback on their prescribing performance. Clinical decision support systems (CDSS) and audit and feedback interventions have shown some impact, but changes are often short-lived. Interactive dashboards, a novel approach integrating CDSS and audit and feedback elements, offer longitudinal updated data outside clinical encounters. This systematic review aims to explore the effectiveness of interactive dashboards on prescribing-related outcomes in primary care and examine the characteristics of these dashboards.

METHODS

This protocol was prospectively registered on PROSPERO (CRD42023481475) and reported in line with PRISMA-P guidelines. Searches of PubMed, EMBASE, Medline, PsychINFO, CINAHL, Scopus, the Cochrane Library, and grey literature, including trial registries were performed to identify interventional studies (randomised and non-randomised) that assess the effectiveness of interactive dashboards on prescribing related outcomes. The search will be supplemented by searching references of retrieved articles with the use of an automated citation chaser. Identified records will be screened independently by two reviewers and data from eligible studies extracted using a purposely developed data extraction tool. We will narratively summarise the intervention types and those associated with improvements in prescribing outcomes. A quantitative synthesis will be carried out if a sufficient number of homogenous studies are identified. Methodological quality will be assessed by two reviewers using the Cochrane Effective Practice and Organisation of Care risk assessment tool.

DISCUSSION

This systematic review will explore the effect of interactive dashboards on prescribing related outcome measures in primary care and describe the characteristics of interactive dashboards. This research may inform future intervention development and shape policymaking particularly in the context of ongoing and planned developments in e-prescribing infrastructure.

摘要

引言

治疗方法和医疗保健的进步导致患有多种疾病和使用多种药物的人群不断增加,这使得开药变得更具挑战性。大多数开药工作在初级保健中进行,全科医生(GP)对关于其开药表现的比较反馈表示出兴趣。临床决策支持系统(CDSS)以及审核与反馈干预措施已显示出一定影响,但变化往往是短暂的。交互式仪表板是一种整合了CDSS和审核与反馈元素的新方法,可在临床诊疗之外提供纵向更新数据。本系统评价旨在探讨交互式仪表板对初级保健中与开药相关结果的有效性,并研究这些仪表板的特征。

方法

本方案已在PROSPERO(CRD42023481475)上进行前瞻性注册,并按照PRISMA-P指南进行报告。对PubMed、EMBASE、Medline、PsychINFO、CINAHL、Scopus、Cochrane图书馆以及灰色文献(包括试验注册库)进行检索,以识别评估交互式仪表板对与开药相关结果有效性的干预性研究(随机和非随机)。检索将通过使用自动引文追踪器搜索检索到文章的参考文献来补充。确定的记录将由两名评审员独立筛选,并使用专门开发的数据提取工具提取符合条件研究的数据。我们将对干预类型以及与开药结果改善相关的类型进行叙述性总结。如果确定了足够数量的同类研究,则将进行定量综合分析。两名评审员将使用Cochrane有效实践和护理组织风险评估工具评估方法学质量。

讨论

本系统评价将探讨交互式仪表板对初级保健中与开药相关结果指标的影响,并描述交互式仪表板的特征。这项研究可能为未来的干预措施开发提供信息,并影响政策制定,特别是在电子处方基础设施正在进行和计划中的发展背景下。

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