Clinical decision support systems for palliative care management : a scoping review

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DOS SANTOS, Fabiana Cristina | SNIGURSKA, Urszula A. | KEENAN, Gail M. | LUCERO, Robert J. | MODAVE, François

INTRODUCTION: With the expansion of palliative care services in clinical settings, clinical decision support systems (CDSSs) have become increasingly crucial for assisting bedside nurses and other clinicians in improving the quality of care to patients with life-limiting health conditions. OBJECTIVE: To characterize palliative care CDSSs and explore end-users' actions taken, adherence recommendations, and clinical decision time. METHOD: The CINAHL, Embase, and PubMed databases were searched from inception to September 2022. The review was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Qualified studies were described in tables and assessed the level of evidence. RESULTS: A total of 284 abstracts were screened, and twelve studies comprised the final sample. The CDSSs focused on identifying patients who could benefit from palliative care based on their health status, making referrals to palliative care services, and managing medications and symptom control. Studies explored the impact of decision support systems on end-user adherence, with many resulting in low adherence to tasks and recommendations. Lack of feature customization and trust in the initial stages of feasibility and usability testing were evident, limiting the usefulness for nurses and other clinicians. CONCLUSION: This study demonstrated that implementing palliative care CDSSs can assist nurses and other clinicians in improving the quality of care for dying patients. Further research utilizing rigorous methods to evaluate the impact of clinical decision support features and guideline-based actions on clinicians' adherence and efficiency is recommended.

http://dx.doi.org/10.1016/j.jpainsymman.2023.03.006

Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 66»

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