慢性阻塞性肺病
肺病
医学
叙述性评论
定性研究
信息系统
重症监护医学
医疗急救
护理部
工程类
社会科学
社会学
内科学
精神科
电气工程
作者
Adeola Bamgboje‐Ayodele,David N Borg,Steven McPhail,Melissa T. Baysari
标识
DOI:10.1177/20552076231219107
摘要
Objectives To synthesise the literature on clinical decision support (CDS) systems for chronic obstructive pulmonary disease (COPD). We aimed to (1) describe existing COPD CDS systems that have been designed, developed or are being used in practice, (2) describe the impact of COPD CDS systems on outcomes and (3) identify barriers and facilitators to implementation of COPD CDS systems. Methods Five databases were searched to identify relevant studies. All studies in English that described clinician-facing COPD CDS systems designed for, or implemented in, hospitals and hospital-in-the-home settings were included. A qualitative narrative synthesis was undertaken, guided by the RE-AIM framework ( Reach, Effectiveness, Adoption, Implementation and Maintenance). Results Twelve studies reporting the use of CDS in hospital ( n = 7) and hospital-in-the-home ( n = 5) settings were included. Implementation efforts to reach target users were scantly reported, and low-to-medium adoption rates were observed. The reported effectiveness of the CDS systems was mixed. Only one study reported facilitators to the implementation of CDS systems, none reported on barriers to the implementation of CDS systems, and none reported any information on successful strategies to maintain implementation of CDS systems. Conclusion The use of CDS systems in the management of patients with COPD in hospital-related settings is an important emerging field of research. Evidence suggests that the field has largely focused on systems targeted at physicians, often with incomplete descriptions and limited evaluations. Many opportunities to optimise and evaluate the implementation and use of COPD CDS systems in hospital settings remain, including robust evaluation of their impact on patient, clinician and health service outcomes.
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