Provider response to computer-based care suggestions for chronic heart failure.
Objectives: We sought to assess the responses of providers to recommendations generated by a computer-management system for chronic heart failure (CHF).Methods: This study is an analysis of primary care providers' responses to evidence-based computer-generated suggestions regarding patients with CHF...
| Publicado en: | Medical Care Vol. 43; no. 5; pp. 461 - 466 |
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| Autores principales: | , , , , , , |
| Formato: | clinical trial research randomized controlled trial Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
May2005
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=138251519&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 138251519 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257079 21B jtl: Medical Care issn: 00257079 maglogo: N pubinfo: dt: May2005 vid: 43 iid: 5 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 138251519 138251519 NLM15838410 138251519 10.1097/01.mlr.0000160378.53326.f3 NLM15838410 138251519 ppf: 461 ppct: 5 formats: tig: atl: Provider response to computer-based care suggestions for chronic heart failure. aug: au: Keeffe, Brian Subramanian, Usha Tierney, William M Udris, Edmunds Willems, Jim McDonell, Mary Fihn, Stephan D affil: Northwest Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, Washington, USA sug: subj: Decision Support Systems, Clinical Attitude of Health Personnel Heart Failure Therapy Guideline Adherence Physicians, Family Education Primary Health Care Standards Physicians, Family Psychosocial Factors Hospitals, Veterans Standards Washington Indiana Human Patient Centered Care Practice Guidelines Dissent and Disputes Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials ab: Objectives: We sought to assess the responses of providers to recommendations generated by a computer-management system for chronic heart failure (CHF).Methods: This study is an analysis of primary care providers' responses to evidence-based computer-generated suggestions regarding patients with CHF at one center of a randomized trial. The trial randomized primary care providers from 2 VA Medical Centers to receive care suggestions regarding patients with CHF, with or without inclusion of patient symptom data obtained from pre-visit questionnaires. At one center, providers were asked to respond to the suggestions with hand-written comments and a numerical agreement scale.Results: Providers responded to 774 care suggestions (62% of the 1246 delivered). They agreed with 41%, had major disagreements with 12%, and had minor disagreements with 22%. For 7% of the care suggestions, providers asked to not see it again for that patient. The most common reasons for major or minor disagreements were a belief that the suggestion was wrong or unnecessary (45%) or would not be tolerated by the patient (32%). External barriers to implementation of guidelines, lack of guideline awareness, or disagreement with guidelines were uncommon reasons cited by providers in this study.Conclusions: Providers agreed with less than half of computer-generated care suggestions from evidence-based CHF guidelines, most often because the suggestions were felt to be inapplicable to their patients or unlikely to be tolerated. pubtype: Academic Journal doctype: clinical trial research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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