Feasibility, acceptability and impact of a clinical decision support tool among primary care providers in an urban, rural and remote site in the Philippines.
Autor: | Calderon Y; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Sandigan G; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Tan-Lim CSC; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines cctan7@up.edu.ph.; Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines., De Mesa RYH; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Fabian NMC; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Rey MP; Department of Accounting and Finance, Cesar E.A. Virata School of Business, University of the Philippines Diliman, Quezon City, Philippines., Sanchez JT; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Dans LF; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines.; Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines., Galingana CLT; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Bernal-Sundiang N; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Casile RU; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Aquino MRN; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Poblete KE; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Lopez JFE; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Zabala H; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines., Dans AL; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines.; National Institutes of Health, University of the Philippines Manila, Manila, Metro Manila, Philippines. |
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Jazyk: | angličtina |
Zdroj: | BMJ open quality [BMJ Open Qual] 2024 Feb 29; Vol. 13 (1). Date of Electronic Publication: 2024 Feb 29. |
DOI: | 10.1136/bmjoq-2023-002526 |
Abstrakt: | Introduction: Strengthening primary care helps address health inequities that continue to persist in the Philippines. The Philippine Primary Care Studies pilot-tested interventions to improve the primary care system. One intervention was the provision of a free subscription to an electronic decision support application called UpToDate (UTD) for primary care providers (PCPs), including doctors, nurses, midwives and community health workers (CHWs). This study aimed to (1) assess the feasibility of using UTD as information source for PCPs in urban, rural and remote settings, (2) determine the acceptability of UTD as an information source for PCPs and (3) examine the impact of UTD access on PCP clinical decision-making. Methods: Four focus group discussions (FGDs) and two key informant interviews (KII) were conducted to gather insights from 30 PCPs. Thematic analysis through coding in NVivo V.12 was done using the technology acceptance model (TAM) as a guiding framework. Results: All PCPs had positive feedback regarding UTD use because of its comprehensiveness, accessibility, mobility and general design. The participants relayed UTD's benefit for point-of-contact use, capacity-building and continuing professional development. PCPs across the three sites, including CHWs with no formal medical education, were able to provide evidence-based medical advice to patients through UTD. However, external factors in these settings impeded the full integration of UTD in the PCPs' workflow, including poor internet access, unstable sources of electricity, lack of compatible mobile devices and the need for translation to the local language. Conclusion: UTD was a feasible and acceptable clinical decision support tool for the PCPs. Factors affecting the feasibility of using UTD include technological and environmental factors (ie, internet access and the lack of translation to the local language), as well as the organisational structure of the primary care facility which determines the roles of the PCPs. Despite the difference in roles and responsibilities of the PCPs, UTD positively impacted decision-making and patient education for all PCPs through its use as a point-of-contact tool and a tool for capacity-building. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) |
Databáze: | MEDLINE |
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