Clinical decision support methods for children and youths with mental health disorders in primary care

Abstract

Background Mental health disorders among children and youths are common and often have negative consequences for children, youths, and families if unrecognized and untreated. With the goal of early recognition, primary care physicians (PCPs) play a significant role in the detection and referral of mental disorders. However, PCPs report several barriers related to confidence, knowledge, and interdisciplinary collaboration. Therefore, initiatives have been taken to assist PCPs in their clinical decision-making through clinical decision support methods (CDSMs). Objectives This review aimed to identify CDSMs in the literature and describe their functionalities and quality. Methods In this review, a search strategy was performed to access all available studies in PubMed, PsychINFO, Embase, Web of Science, and COCHRANE using keywords. Studies that involved CDSMs for PCP clinical decision-making regarding psychosocial or psychiatric problems among children and youths (0–24 years old) were included. The search was conducted according to PRISMA-Protocols. Results Of 1,294 studies identified, 25 were eligible for inclusion and varied in quality. Eighteen CDSMs were described. Fourteen studies described computer-based methods with decision support, focusing on self-help, probable diagnosis, and treatment suggestions. Nine studies described telecommunication methods, which offered support through interdisciplinary (video) calls. Two studies described CDSMs with a combination of components related to the two CDSM categories. Conclusion Easy-to-use CDSMs of good quality are valuable for advising PCPs on the detection and referral of children and youths with mental health disorders. However, valid multicentre research on a combination of computer-based methods and telecommunication is still needed.

Between‐hospital variation in clinical decision support availability for common inpatient pediatric conditions: Results of a national Pediatric Research in Inpatient Settings (PRĪS) Network survey

“…11 CDS usage in a variety of settings has been associated with improved patient care processes or outcomes for these diagnoses. [12][13][14][15][16][17][18][19] The survey included EHR vendor-agnostic operational definitions of each CDS tool type that appeared when the respondent hovered over the corresponding response option to aid in their understanding. Upon receipt of the survey invitation, site leads were given the option to forward the invitation to a colleague more familiar with CDS at their site.…”

“…Diagnoses were chosen based upon epidemiologic research identifying the most frequently encountered conditions in inpatient pediatric hospital medicine 11 . CDS usage in a variety of settings has been associated with improved patient care processes or outcomes for these diagnoses 12–19 . The survey included EHR vendor‐agnostic operational definitions of each CDS tool type that appeared when the respondent hovered over the corresponding response option to aid in their understanding.…”

Letter to the Editor: Addressing Children’s Mental Health Issues Related to Economic Changes Caused by the COVID-19 Pandemic

“…CDSMs analyze patients’ conditions and provide support regarding treatment or referral. Computer-based CDSMs focus on selfhelp, diagnosis, and treatment suggestions, while telecommunication methods offer support using interdisciplinary (video) calls [ 5 ]. Second, equally important is the availability of mental health services that cater to the needs of the young, be it in-person or online.…”