PDF(Pubmed)
Abstract：
BACKGROUND: Primary care plays a key role in the management of type 2 diabetes. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been demonstrated to reduce hospitalization and cardiac and renal complications. Tools that optimize management, including appropriate prescribing, are a priority for treating chronic diseases. Future Health Today (FHT) is software that facilitates clinical decision support and quality improvement. FHT applies algorithms to data stored in electronic medical records in general practice to identify patients who are at risk of a chronic disease or who have a chronic disease that may benefit from intensification of management. The platform continues to evolve because of rigorous evaluation, continuous improvement, and expansion of the conditions hosted on the platform. FHT currently displays recommendations for the identification and management of chronic kidney disease, cardiovascular disease, type 2 diabetes, and cancer risk. A new module will be introduced to FHT focusing on SGLT2 inhibitors in patients with type 2 diabetes who have chronic kidney diseases, cardiovascular diseases, or risk factors for cardiovascular disease.
OBJECTIVE: The study aims to explore the barriers and enablers to the implementation of an SGLT2 inhibitor module within the Future Health Today software.
METHODS: Clinic staff were recruited to participate in interviews on their experience in their use of a tool to improve prescribing behavior for SGLT2 inhibitors. Thematic analysis was guided by Clinical Performance Feedback Intervention Theory.
RESULTS: In total, 16 interviews were completed. Identified enablers of use included workflow alignment, clinical appropriateness, and active delivery of the module. Key barriers to use were competing priorities, staff engagement, and knowledge of the clinical topic.
CONCLUSIONS: There is a recognized benefit to the use of a clinical decision support tool to support type 2 diabetes management, but barriers were identified that impeded the usability and actionability of the module. Successful and effective implementation of this tool could support the optimization of patient management of type 2 diabetes in primary care.
OBJECTIVE: The study aims to explore the barriers and enablers to the implementation of an SGLT2 inhibitor module within the Future Health Today software.
METHODS: Clinic staff were recruited to participate in interviews on their experience in their use of a tool to improve prescribing behavior for SGLT2 inhibitors. Thematic analysis was guided by Clinical Performance Feedback Intervention Theory.
RESULTS: In total, 16 interviews were completed. Identified enablers of use included workflow alignment, clinical appropriateness, and active delivery of the module. Key barriers to use were competing priorities, staff engagement, and knowledge of the clinical topic.
CONCLUSIONS: There is a recognized benefit to the use of a clinical decision support tool to support type 2 diabetes management, but barriers were identified that impeded the usability and actionability of the module. Successful and effective implementation of this tool could support the optimization of patient management of type 2 diabetes in primary care.
摘要：
背景：初级保健在2型糖尿病的治疗中起着关键作用。钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂已被证明可以减少住院以及心脏和肾脏并发症。优化管理的工具，包括适当的处方，是治疗慢性疾病的优先事项。FutureHealthToday（FHT）是一种软件，可促进临床决策支持和质量改进。FHT将算法应用于一般实践中存储在电子病历中的数据，以识别有慢性病风险的患者或可能受益于强化管理的慢性病患者。由于严格的评估，该平台继续发展，持续改进,和扩展平台上托管的条件。FHT目前显示慢性肾脏疾病的识别和管理的建议，心血管疾病,2型糖尿病,和癌症风险。FHT将引入一个新模块，专注于患有慢性肾脏疾病的2型糖尿病患者的SGLT2抑制剂，心血管疾病,或心血管疾病的危险因素。
目的：本研究旨在探索在FutureHealthToday软件中实施SGLT2抑制剂模块的障碍和促成因素。
方法：招募临床工作人员参加访谈，了解他们使用一种工具改善SGLT2抑制剂处方行为的经验。主题分析以临床表现反馈干预理论指导。
结果：总计，完成了16次面试。确定的使用促成者包括工作流对齐，临床适当性，和模块的积极交付。使用的主要障碍是相互竞争的优先事项，工作人员参与,和临床主题的知识。
结论：使用临床决策支持工具支持2型糖尿病管理是公认的益处，但是发现了阻碍模块可用性和可操作性的障碍。该工具的成功和有效实施可以支持初级保健中2型糖尿病患者管理的优化。
目的：本研究旨在探索在FutureHealthToday软件中实施SGLT2抑制剂模块的障碍和促成因素。
方法：招募临床工作人员参加访谈，了解他们使用一种工具改善SGLT2抑制剂处方行为的经验。主题分析以临床表现反馈干预理论指导。
结果：总计，完成了16次面试。确定的使用促成者包括工作流对齐，临床适当性，和模块的积极交付。使用的主要障碍是相互竞争的优先事项，工作人员参与,和临床主题的知识。
结论：使用临床决策支持工具支持2型糖尿病管理是公认的益处，但是发现了阻碍模块可用性和可操作性的障碍。该工具的成功和有效实施可以支持初级保健中2型糖尿病患者管理的优化。
