The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder study
Abstract Background This study explored the feasibility of integrating a clinical decision support tool into general practice clinical management software in Australia to prompt for alcohol screening among patients who are pregnant or planning a pregnancy. The study aimed to increase understanding o...
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BMC
2024-12-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-024-02662-4 |
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| author | Rachel Canaway Libby Dai Christine Hallinan Cassandra Caddy Kelsey Hegarty Douglas Boyle |
| author_facet | Rachel Canaway Libby Dai Christine Hallinan Cassandra Caddy Kelsey Hegarty Douglas Boyle |
| author_sort | Rachel Canaway |
| collection | DOAJ |
| description | Abstract Background This study explored the feasibility of integrating a clinical decision support tool into general practice clinical management software in Australia to prompt for alcohol screening among patients who are pregnant or planning a pregnancy. The study aimed to increase understanding of what is an appropriate and acceptable clinical decision support tool, the circumstances when a prompt to use such a screening tool should occur, and the barriers and enablers of successful implementation. Methods This feasibility study employed a mixed methods approach and purposive sampling to identify key stakeholders to interview. Participants included vendors of clinical software used in Australian general practice, clinicians in general practice, and relevant others. Data from a literature review and 23 interviews were analysed leading to recommendations which were ‘sense-tested’ by an additional 22 stakeholders. Results Although there are at least 18 clinical software packages used in Australian general practice, it is feasible to integrate an alcohol screening tool for pregnancy into software for the majority of general practices in Australia. The AUDIT-C alcohol screening tool for pregnancy was widely accepted as suitable for such a purpose. Clinicians suggested the greatest barriers to screening were lack of time within antenatal consultations and insufficient remuneration for longer consultations. Many clinicians saw opportunity for introducing a multifunctional antenatal tool that could incorporate screening and clinical decision support for alcohol, tobacco and other substance use, mental health, domestic and family violence and potentially other areas informing healthy pregnancy. It could also be used opportunistically for preconception screening and counselling. Deployment of the tool could be supported by an education campaign from professional associations. Conclusion The integration of a tool for screening for alcohol use among women who are pregnant or planning pregnancy into general practice clinical software is feasible; however, a multifunctional antenatal screening tool, incorporating other psychosocial elements, was considered more useful than a stand-alone alcohol screening tool. Codesign is needed with vendors and end-users to develop an acceptable tool that can be widely implemented. Issues with GP renumeration need also to be addressed to encourage alcohol screening pre-pregnancy and in the early months of pregnancy. |
| format | Article |
| id | doaj-art-07c9e30404fb402e8a9c7cdacbbafd7f |
| institution | Kabale University |
| issn | 2731-4553 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-07c9e30404fb402e8a9c7cdacbbafd7f2024-12-08T12:38:49ZengBMCBMC Primary Care2731-45532024-12-0125111910.1186/s12875-024-02662-4The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder studyRachel Canaway0Libby Dai1Christine Hallinan2Cassandra Caddy3Kelsey Hegarty4Douglas Boyle5Department of General Practice and Primary Care, The University of MelbourneDepartment of General Practice and Primary Care, The University of MelbourneDepartment of General Practice and Primary Care, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneDepartment of General Practice and Primary Care, The University of MelbourneDepartment of General Practice and Primary Care, The University of MelbourneAbstract Background This study explored the feasibility of integrating a clinical decision support tool into general practice clinical management software in Australia to prompt for alcohol screening among patients who are pregnant or planning a pregnancy. The study aimed to increase understanding of what is an appropriate and acceptable clinical decision support tool, the circumstances when a prompt to use such a screening tool should occur, and the barriers and enablers of successful implementation. Methods This feasibility study employed a mixed methods approach and purposive sampling to identify key stakeholders to interview. Participants included vendors of clinical software used in Australian general practice, clinicians in general practice, and relevant others. Data from a literature review and 23 interviews were analysed leading to recommendations which were ‘sense-tested’ by an additional 22 stakeholders. Results Although there are at least 18 clinical software packages used in Australian general practice, it is feasible to integrate an alcohol screening tool for pregnancy into software for the majority of general practices in Australia. The AUDIT-C alcohol screening tool for pregnancy was widely accepted as suitable for such a purpose. Clinicians suggested the greatest barriers to screening were lack of time within antenatal consultations and insufficient remuneration for longer consultations. Many clinicians saw opportunity for introducing a multifunctional antenatal tool that could incorporate screening and clinical decision support for alcohol, tobacco and other substance use, mental health, domestic and family violence and potentially other areas informing healthy pregnancy. It could also be used opportunistically for preconception screening and counselling. Deployment of the tool could be supported by an education campaign from professional associations. Conclusion The integration of a tool for screening for alcohol use among women who are pregnant or planning pregnancy into general practice clinical software is feasible; however, a multifunctional antenatal screening tool, incorporating other psychosocial elements, was considered more useful than a stand-alone alcohol screening tool. Codesign is needed with vendors and end-users to develop an acceptable tool that can be widely implemented. Issues with GP renumeration need also to be addressed to encourage alcohol screening pre-pregnancy and in the early months of pregnancy.https://doi.org/10.1186/s12875-024-02662-4Alcohol useAntenatal careAustraliaClinical decision support systemsFeasibility studiesGeneral practice |
| spellingShingle | Rachel Canaway Libby Dai Christine Hallinan Cassandra Caddy Kelsey Hegarty Douglas Boyle The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder study BMC Primary Care Alcohol use Antenatal care Australia Clinical decision support systems Feasibility studies General practice |
| title | The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder study |
| title_full | The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder study |
| title_fullStr | The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder study |
| title_full_unstemmed | The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder study |
| title_short | The feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software: a review and Australian key stakeholder study |
| title_sort | feasibility of integrating an alcohol screening clinical decision support tool into primary care clinical software a review and australian key stakeholder study |
| topic | Alcohol use Antenatal care Australia Clinical decision support systems Feasibility studies General practice |
| url | https://doi.org/10.1186/s12875-024-02662-4 |
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