Development and evaluation of a mobile decision support system for hypertension management in the primary care setting in Brazil : mixed-methods rield study on usability, feasibility, and utility
| Autor: | Milena Soriano Marcolino, Elmiro Santos Resende, Daniel Vitorio Silveira, Camila G Ferreira, Antonio Luiz Pinho Ribeiro, Elaine Leandro Machado, Andre Pires Antunes, Bárbara Couto Carvalho, Maria Beatriz Moreira Alkmim |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Decision support system Telemedicine Technology Assessment Biomedical hypertension Health Informatics Context (language use) Information technology 030204 cardiovascular system & hematology Clinical decision support system Decision Support Techniques 03 medical and health sciences 0302 clinical medicine Software Design cardiovascular disease Surveys and Questionnaires medicine Humans 030212 general & internal medicine Risk factor Original Paper Primary Health Care business.industry Self-Management Usability Middle Aged medicine.disease T58.5-58.64 Cardiovascular disease Mobile Applications Blood pressure clinical decision support system Feasibility Studies Female Medical emergency telemedicine Public aspects of medicine RA1-1270 Risk assessment business Brazil |
| Zdroj: | Repositório Institucional da UFOP Universidade Federal de Ouro Preto (UFOP) instacron:UFOP JMIR mHealth and uHealth JMIR mHealth and uHealth, Vol 7, Iss 3, p e9869 (2019) |
| Popis: | BackgroundDespite being an important cardiovascular risk factor, hypertension has low control levels worldwide. Computerized clinical decision support systems (CDSSs) might be effective in reducing blood pressure with a potential impact in reducing cardiovascular risk. ObjectiveThe goal of the research was to evaluate the feasibility, usability, and utility of a CDSS, TeleHAS (tele–hipertensão arterial sistêmica, or arterial hypertension system), in the care of patients with hypertension in the context of a primary care setting in a middle-income country. MethodsThe TeleHAS app consists of a platform integrating clinical and laboratory data on a particular patient, from which it performs cardiovascular risk calculation and provides evidence-based recommendations derived from Brazilian and international guidelines for the management of hypertension and cardiovascular risk. Ten family physicians from different primary care units in the city of Montes Claros, Brazil, were randomly selected to use the CDSS for the care of hypertensive patients for 6 months. After 3 and 6 months, the feasibility, usability, and utility of the CDSS in the routine care of the health team was evaluated through a standardized questionnaire and semistructured interviews. ResultsThroughout the study, clinicians registered 535 patients with hypertension, at an average of 1.24 consultations per patient. Women accounted for 80% (8/10) of participant doctors, median age was 31.5 years (interquartile range 27 to 59 years). As for feasibility, 100% of medical users claimed it was possible to use the app in the primary care setting, and for 80% (8/10) of them it was easy to incorporate its use into the daily routine and home visits. Nevertheless, 70% (7/10) of physicians claimed that the time taken to fill out the CDSS causes significant delays in service. Clinicians evaluated TeleHAS as good (8/10, 80% of users), with easy completion and friendly interface (10/10, 100%) and the potential to improve patients’ treatment (10/10, 100%). A total of 90% (9/10) of physicians had access to new knowledge about cardiovascular risk and hypertension through the app recommendations and found it useful to promote prevention and optimize treatment. ConclusionsIn this study, a CDSS developed to assist the management of patients with hypertension was feasible in the context of a primary health care setting in a middle-income country, with good user satisfaction and the potential to improve adherence to evidence-based practices. |
| Databáze: | OpenAIRE |
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