Implementing patient decision aids into general practice clinical decision support systems: Feasibility study in cardiovascular disease prevention

Cornell, Samuel; Doust, Jenny; Morgan, Mark; Greaves, Kim; Hawkes, Anna L.; Wet, Carl de; O’Connor, Denise; Bonner, Carissa

doi:10.1016/j.pecinn.2023.100140

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…The app could auto-populate our decision support tools from medical records in two different clinical audit systems, requiring a single click from the GP. This is described in more detail in a separate paper (31).…”

Section: Intervention Materialsmentioning

confidence: 99%

Implementing shared decision making support for cardiovascular disease prevention: Stakeholder interviews and case studies in Australian primary care

Bonner,

Cornell,

Pickles

et al. 2023

Preprint

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Background: Australian cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk assessment, but less than half of eligible patients have the required risk factors recorded due to fragmented implementation over the last decade. Co-designed decision support tools for general practitioners (GPs) and consumers have been developed that improve knowledge barriers to guideline-recommended CVD risk assessment and management. This study used a stakeholder consultation process to identify and pilot test the feasibility of implementation strategies for these decision support tools in Australian primary care. Methods: This work was based on the Multiphase Optimisation Strategy (MOST) framework and included: 1) stakeholder consultation to map existing implementation strategies (2018-20); 2) interviews with 29 Primary Health Network (PHN) staff from all Australian states and territories to identify new implementation opportunities (2021); 3) pilot testing the feasibility of low, medium, and high resource implementation strategies (2019-21). Framework Analysis was used for qualitative data and Google analytics provided decision support usage data over time. Results: Informal stakeholder discussions indicated a need to partner with existing programs delivered by the Heart Foundation and PHNs. PHN interviews identified the importance of linking decision support tools with GP education resources, quality improvement activities, and consumer-focused prevention programs. Participants highlighted the importance of taking account of general practice processes, such as business models, workflows, medical records and clinical audit software. Specific implementation strategies were identified as feasible to pilot during COVID-19: 1) low resource: adding website links to local health area guidelines for clinicians and a Heart Foundation toolkit for primary care providers; 2) medium resource: presenting at GP education conferences and integrating the resources into audit and feedback reports; 3) high resource: auto-populate the risk assessment and decision aids from patient records via clinical audit software. Conclusions: This research identified a wide range of feasible strategies to implement decision support tools for CVD risk assessment and management. The findings will inform the translation of new CVD guidelines in primary care. Future research will use economic evaluation to explore the added value of higher versus lower resource implementation strategies.

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Section: Intervention Materialsmentioning

confidence: 99%

Implementing shared decision making support for cardiovascular disease prevention: Stakeholder interviews and case studies in Australian primary care

Bonner,

Cornell,

Pickles

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

How do general practitioners manage patient health literacy differences in cardiovascular disease prevention consultations? An interview study

McKinn,

Chapman,

Sharman

et al. 2024

Patient Education and Counseling

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Implementing decision aids for cardiovascular disease prevention: stakeholder interviews and case studies in Australian primary care

Bonner,

Cornell,

Pickles

et al. 2024

BMC Prim. Care

View full text Add to dashboard Cite

Background Australian cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk assessment, but less than half of eligible patients have the required risk factors recorded due to fragmented implementation over the last decade. Co-designed decision aids for general practitioners (GPs) and consumers have been developed that improve knowledge barriers to guideline-recommended CVD risk assessment and management. This study used a stakeholder consultation process to identify and pilot test the feasibility of implementation strategies for these decision aids in Australian primary care. Methods This mixed methods study included: (1) stakeholder consultation to map existing implementation strategies (2018-20); (2) interviews with 29 Primary Health Network (PHN) staff from all Australian states and territories to identify new implementation opportunities (2021); (3) pilot testing the feasibility of low, medium, and high resource implementation strategies (2019-21). Framework Analysis was used for qualitative data and Google analytics provided decision support usage data over time. Results Informal stakeholder discussions indicated a need to partner with existing programs delivered by the Heart Foundation and PHNs. PHN interviews identified the importance of linking decision aids with GP education resources, quality improvement activities, and consumer-focused prevention programs. Participants highlighted the importance of integration with general practice processes, such as business models, workflows, medical records and clinical audit software. Specific implementation strategies were identified as feasible to pilot during COVID-19: (1) low resource: adding website links to local health area guidelines for clinicians and a Heart Foundation toolkit for primary care providers; (2) medium resource: presenting at GP education conferences and integrating the resources into audit and feedback reports; (3) high resource: auto-populate the risk assessment and decision aids from patient records via clinical audit software. Conclusions This research identified a wide range of feasible strategies to implement decision aids for CVD risk assessment and management. The findings will inform the translation of new CVD guidelines in primary care. Future research will use economic evaluation to explore the added value of higher versus lower resource implementation strategies.

show abstract

Implementing patient decision aids into general practice clinical decision support systems: Feasibility study in cardiovascular disease prevention

Cited by 3 publications

References 33 publications

Implementing shared decision making support for cardiovascular disease prevention: Stakeholder interviews and case studies in Australian primary care

Implementing shared decision making support for cardiovascular disease prevention: Stakeholder interviews and case studies in Australian primary care

How do general practitioners manage patient health literacy differences in cardiovascular disease prevention consultations? An interview study

Implementing decision aids for cardiovascular disease prevention: stakeholder interviews and case studies in Australian primary care

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