Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey
Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Ploegmakers, Kim J. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2022 |
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| Schlagwörter: |
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| Anmerkung: |
© The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 |
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| Übergeordnetes Werk: |
Enthalten in: European geriatric medicine - [Cham] : Springer International Publishing, 2010, 13(2022), 2 vom: 15. Jan., Seite 395-405 |
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| Übergeordnetes Werk: |
volume:13 ; year:2022 ; number:2 ; day:15 ; month:01 ; pages:395-405 |
| Links: |
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| DOI / URN: |
10.1007/s41999-021-00599-w |
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SPR04679770X |
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| 100 | 1 | |a Ploegmakers, Kim J. |e verfasserin |0 (orcid)0000-0002-5772-8057 |4 aut | |
| 245 | 1 | 0 | |a Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey |
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| 500 | |a © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 | ||
| 520 | |a Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. | ||
| 520 | |a Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. | ||
| 650 | 4 | |a Clinical Decision Support System (CDSS) |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Barriers |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Facilitators |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Medication review |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Falls prevention |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Landi, Francesco |4 aut | |
| 700 | 1 | |a Thaler, Heinrich |4 aut | |
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10.1007/s41999-021-00599-w doi (DE-627)SPR04679770X (SPR)s41999-021-00599-w-e DE-627 ger DE-627 rakwb eng Ploegmakers, Kim J. verfasserin (orcid)0000-0002-5772-8057 aut Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. Clinical Decision Support System (CDSS) (dpeaa)DE-He213 Barriers (dpeaa)DE-He213 Facilitators (dpeaa)DE-He213 Medication review (dpeaa)DE-He213 Falls prevention (dpeaa)DE-He213 Medlock, Stephanie (orcid)0000-0002-2679-8095 aut Linn, Annemiek J. (orcid)0000-0003-0912-3712 aut Lin, Yumin aut Seppälä, Lotta J. (orcid)0000-0001-9197-1424 aut Petrovic, Mirko (orcid)0000-0002-7506-8646 aut Topinkova, Eva (orcid)0000-0002-6786-4116 aut Ryg, Jesper (orcid)0000-0002-8641-3062 aut Mora, Maria Angeles Caballero (orcid)0000-0001-5913-516X aut Landi, Francesco aut Thaler, Heinrich aut Szczerbińska, Katarzyna (orcid)0000-0002-0004-3858 aut Hartikainen, Sirpa (orcid)0000-0002-4714-455X aut Bahat, Gulistan (orcid)0000-0001-5343-9795 aut Ilhan, Birkan (orcid)0000-0001-6039-5866 aut Morrissey, Yvonne aut Masud, Tahir (orcid)0000-0003-1061-2898 aut van der Velde, Nathalie (orcid)0000-0002-6477-6209 aut van Weert, Julia C. M. (orcid)0000-0002-2259-5864 aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 13(2022), 2 vom: 15. Jan., Seite 395-405 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:13 year:2022 number:2 day:15 month:01 pages:395-405 https://dx.doi.org/10.1007/s41999-021-00599-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 13 2022 2 15 01 395-405 |
| spelling |
10.1007/s41999-021-00599-w doi (DE-627)SPR04679770X (SPR)s41999-021-00599-w-e DE-627 ger DE-627 rakwb eng Ploegmakers, Kim J. verfasserin (orcid)0000-0002-5772-8057 aut Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. Clinical Decision Support System (CDSS) (dpeaa)DE-He213 Barriers (dpeaa)DE-He213 Facilitators (dpeaa)DE-He213 Medication review (dpeaa)DE-He213 Falls prevention (dpeaa)DE-He213 Medlock, Stephanie (orcid)0000-0002-2679-8095 aut Linn, Annemiek J. (orcid)0000-0003-0912-3712 aut Lin, Yumin aut Seppälä, Lotta J. (orcid)0000-0001-9197-1424 aut Petrovic, Mirko (orcid)0000-0002-7506-8646 aut Topinkova, Eva (orcid)0000-0002-6786-4116 aut Ryg, Jesper (orcid)0000-0002-8641-3062 aut Mora, Maria Angeles Caballero (orcid)0000-0001-5913-516X aut Landi, Francesco aut Thaler, Heinrich aut Szczerbińska, Katarzyna (orcid)0000-0002-0004-3858 aut Hartikainen, Sirpa (orcid)0000-0002-4714-455X aut Bahat, Gulistan (orcid)0000-0001-5343-9795 aut Ilhan, Birkan (orcid)0000-0001-6039-5866 aut Morrissey, Yvonne aut Masud, Tahir (orcid)0000-0003-1061-2898 aut van der Velde, Nathalie (orcid)0000-0002-6477-6209 aut van Weert, Julia C. M. (orcid)0000-0002-2259-5864 aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 13(2022), 2 vom: 15. Jan., Seite 395-405 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:13 year:2022 number:2 day:15 month:01 pages:395-405 https://dx.doi.org/10.1007/s41999-021-00599-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 13 2022 2 15 01 395-405 |
| allfields_unstemmed |
10.1007/s41999-021-00599-w doi (DE-627)SPR04679770X (SPR)s41999-021-00599-w-e DE-627 ger DE-627 rakwb eng Ploegmakers, Kim J. verfasserin (orcid)0000-0002-5772-8057 aut Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. Clinical Decision Support System (CDSS) (dpeaa)DE-He213 Barriers (dpeaa)DE-He213 Facilitators (dpeaa)DE-He213 Medication review (dpeaa)DE-He213 Falls prevention (dpeaa)DE-He213 Medlock, Stephanie (orcid)0000-0002-2679-8095 aut Linn, Annemiek J. (orcid)0000-0003-0912-3712 aut Lin, Yumin aut Seppälä, Lotta J. (orcid)0000-0001-9197-1424 aut Petrovic, Mirko (orcid)0000-0002-7506-8646 aut Topinkova, Eva (orcid)0000-0002-6786-4116 aut Ryg, Jesper (orcid)0000-0002-8641-3062 aut Mora, Maria Angeles Caballero (orcid)0000-0001-5913-516X aut Landi, Francesco aut Thaler, Heinrich aut Szczerbińska, Katarzyna (orcid)0000-0002-0004-3858 aut Hartikainen, Sirpa (orcid)0000-0002-4714-455X aut Bahat, Gulistan (orcid)0000-0001-5343-9795 aut Ilhan, Birkan (orcid)0000-0001-6039-5866 aut Morrissey, Yvonne aut Masud, Tahir (orcid)0000-0003-1061-2898 aut van der Velde, Nathalie (orcid)0000-0002-6477-6209 aut van Weert, Julia C. M. (orcid)0000-0002-2259-5864 aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 13(2022), 2 vom: 15. Jan., Seite 395-405 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:13 year:2022 number:2 day:15 month:01 pages:395-405 https://dx.doi.org/10.1007/s41999-021-00599-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 13 2022 2 15 01 395-405 |
| allfieldsGer |
10.1007/s41999-021-00599-w doi (DE-627)SPR04679770X (SPR)s41999-021-00599-w-e DE-627 ger DE-627 rakwb eng Ploegmakers, Kim J. verfasserin (orcid)0000-0002-5772-8057 aut Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. Clinical Decision Support System (CDSS) (dpeaa)DE-He213 Barriers (dpeaa)DE-He213 Facilitators (dpeaa)DE-He213 Medication review (dpeaa)DE-He213 Falls prevention (dpeaa)DE-He213 Medlock, Stephanie (orcid)0000-0002-2679-8095 aut Linn, Annemiek J. (orcid)0000-0003-0912-3712 aut Lin, Yumin aut Seppälä, Lotta J. (orcid)0000-0001-9197-1424 aut Petrovic, Mirko (orcid)0000-0002-7506-8646 aut Topinkova, Eva (orcid)0000-0002-6786-4116 aut Ryg, Jesper (orcid)0000-0002-8641-3062 aut Mora, Maria Angeles Caballero (orcid)0000-0001-5913-516X aut Landi, Francesco aut Thaler, Heinrich aut Szczerbińska, Katarzyna (orcid)0000-0002-0004-3858 aut Hartikainen, Sirpa (orcid)0000-0002-4714-455X aut Bahat, Gulistan (orcid)0000-0001-5343-9795 aut Ilhan, Birkan (orcid)0000-0001-6039-5866 aut Morrissey, Yvonne aut Masud, Tahir (orcid)0000-0003-1061-2898 aut van der Velde, Nathalie (orcid)0000-0002-6477-6209 aut van Weert, Julia C. M. (orcid)0000-0002-2259-5864 aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 13(2022), 2 vom: 15. Jan., Seite 395-405 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:13 year:2022 number:2 day:15 month:01 pages:395-405 https://dx.doi.org/10.1007/s41999-021-00599-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 13 2022 2 15 01 395-405 |
| allfieldsSound |
10.1007/s41999-021-00599-w doi (DE-627)SPR04679770X (SPR)s41999-021-00599-w-e DE-627 ger DE-627 rakwb eng Ploegmakers, Kim J. verfasserin (orcid)0000-0002-5772-8057 aut Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. Clinical Decision Support System (CDSS) (dpeaa)DE-He213 Barriers (dpeaa)DE-He213 Facilitators (dpeaa)DE-He213 Medication review (dpeaa)DE-He213 Falls prevention (dpeaa)DE-He213 Medlock, Stephanie (orcid)0000-0002-2679-8095 aut Linn, Annemiek J. (orcid)0000-0003-0912-3712 aut Lin, Yumin aut Seppälä, Lotta J. (orcid)0000-0001-9197-1424 aut Petrovic, Mirko (orcid)0000-0002-7506-8646 aut Topinkova, Eva (orcid)0000-0002-6786-4116 aut Ryg, Jesper (orcid)0000-0002-8641-3062 aut Mora, Maria Angeles Caballero (orcid)0000-0001-5913-516X aut Landi, Francesco aut Thaler, Heinrich aut Szczerbińska, Katarzyna (orcid)0000-0002-0004-3858 aut Hartikainen, Sirpa (orcid)0000-0002-4714-455X aut Bahat, Gulistan (orcid)0000-0001-5343-9795 aut Ilhan, Birkan (orcid)0000-0001-6039-5866 aut Morrissey, Yvonne aut Masud, Tahir (orcid)0000-0003-1061-2898 aut van der Velde, Nathalie (orcid)0000-0002-6477-6209 aut van Weert, Julia C. M. (orcid)0000-0002-2259-5864 aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 13(2022), 2 vom: 15. Jan., Seite 395-405 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:13 year:2022 number:2 day:15 month:01 pages:395-405 https://dx.doi.org/10.1007/s41999-021-00599-w lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 13 2022 2 15 01 395-405 |
| language |
English |
| source |
Enthalten in European geriatric medicine 13(2022), 2 vom: 15. Jan., Seite 395-405 volume:13 year:2022 number:2 day:15 month:01 pages:395-405 |
| sourceStr |
Enthalten in European geriatric medicine 13(2022), 2 vom: 15. Jan., Seite 395-405 volume:13 year:2022 number:2 day:15 month:01 pages:395-405 |
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Article |
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Clinical Decision Support System (CDSS) Barriers Facilitators Medication review Falls prevention |
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European geriatric medicine |
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Ploegmakers, Kim J. @@aut@@ Medlock, Stephanie @@aut@@ Linn, Annemiek J. @@aut@@ Lin, Yumin @@aut@@ Seppälä, Lotta J. @@aut@@ Petrovic, Mirko @@aut@@ Topinkova, Eva @@aut@@ Ryg, Jesper @@aut@@ Mora, Maria Angeles Caballero @@aut@@ Landi, Francesco @@aut@@ Thaler, Heinrich @@aut@@ Szczerbińska, Katarzyna @@aut@@ Hartikainen, Sirpa @@aut@@ Bahat, Gulistan @@aut@@ Ilhan, Birkan @@aut@@ Morrissey, Yvonne @@aut@@ Masud, Tahir @@aut@@ van der Velde, Nathalie @@aut@@ van Weert, Julia C. M. @@aut@@ |
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2022-01-15T00:00:00Z |
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Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome.</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. 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Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey Clinical Decision Support System (CDSS) (dpeaa)DE-He213 Barriers (dpeaa)DE-He213 Facilitators (dpeaa)DE-He213 Medication review (dpeaa)DE-He213 Falls prevention (dpeaa)DE-He213 |
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Ploegmakers, Kim J. Medlock, Stephanie Linn, Annemiek J. Lin, Yumin Seppälä, Lotta J. Petrovic, Mirko Topinkova, Eva Ryg, Jesper Mora, Maria Angeles Caballero Landi, Francesco Thaler, Heinrich Szczerbińska, Katarzyna Hartikainen, Sirpa Bahat, Gulistan Ilhan, Birkan Morrissey, Yvonne Masud, Tahir van der Velde, Nathalie van Weert, Julia C. M. |
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barriers and facilitators in using a clinical decision support system for fall risk management for older people: a european survey |
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Barriers and facilitators in using a Clinical Decision Support System for fall risk management for older people: a European survey |
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Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 |
| abstractGer |
Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 |
| abstract_unstemmed |
Aim The aim of our study was to assess barriers and facilitators to CDSS use reported by European physicians treating older fallers and explore differences in their perceptions. Findings Our main findings were that a barrier to CDSS use is that physicians feel that complex geriatric patients need a physician’s clinical judgement and not the advice of a CDSS. Regional differences in barrier and facilitator perceptions occurred across Europe. Message Our main message is that when designing a CDSS for Geriatric falls patients, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy, and to increase successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Purpose Fall-Risk Increasing Drugs (FRIDs) are an important and modifiable fall-risk factor. A Clinical Decision Support System (CDSS) could support doctors in optimal FRIDs deprescribing. Understanding barriers and facilitators is important for a successful implementation of any CDSS. We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. Equipping a CDSS with prediction models has the potential to provide individualized recommendations for deprescribing FRIDs in older falls patients. © The Author(s), under exclusive licence to European Geriatric Medicine Society 2022 |
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We conducted a European survey to assess barriers and facilitators to CDSS use and explored differences in their perceptions. Methods We examined and compared the relative importance and the occurrence of regional differences of a literature-based list of barriers and facilitators for CDSS usage among physicians treating older fallers from 11 European countries. Results We surveyed 581 physicians (mean age 44.9 years, 64.5% female, 71.3% geriatricians). The main barriers were technical issues (66%) and indicating a reason before overriding an alert (58%). The main facilitators were a CDSS that is beneficial for patient care (68%) and easy-to-use (64%). We identified regional differences, e.g., expense and legal issues were barriers for significantly more Eastern-European physicians compared to other regions, while training was selected less often as a facilitator by West-European physicians. Some physicians believed that due to the medical complexity of their patients, their own clinical judgement is better than advice from the CDSS. Conclusion When designing a CDSS for Geriatric Medicine, the patient’s medical complexity must be addressed whilst maintaining the doctor’s decision-making autonomy. For a successful CDSS implementation in Europe, regional differences in barrier perception should be overcome. 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