Barriers to and facilitators of sustaining a systemic lupus erythematosus (SLE) patient decision aid in regular rheumatology outpatient care in the USA.
Erin E Blanchard, Allyson G Hall, Ezra Gore, Parvaneh Yaghoubi Jami, Aizhan Karabukayeva, Larry R Hearld, Shelby Gontarz, Jasvinder A Singh
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引用次数: 0
Abstract
Objective: This study investigates the barriers to and facilitators of sustaining a decision aid (DA) tool for patients with SLE in routine rheumatology outpatient care across the USA. The DA was initially developed for assisting patients with SLE in making informed medication choices by providing personalized information on their treatment process.
Methods: We conducted semi-structured interviews with clinicians, administrators, and information technology (IT) professionals from 15 geographically diverse rheumatology clinics that participated in a large-scale DA implementation trial. Interviews were transcribed and analysed using NVivo, with thematic coding to identify key factors influencing DA sustainability.
Results: The analysis identified several facilitators, including the DA's user-friendly design and its effectiveness in simplifying complex medical information, aiding informed decision-making for patients with SLE. Challenges affecting DA sustainability included inconsistent staff knowledge about the DA, difficulties integrating the DA into clinical workflows, a lack of executive and physician champions, and a lack of structured training and communication strategies. Additionally, concerns were raised about the availability of staff support and the technological capabilities required to maintain use of the DA.
Conclusion: To sustain the DA in clinical practice, there is a need for enhanced training programs, better workflow integration, in-clinic physician champions, and effective use of electronic medical records for DA dissemination. Addressing these challenges would improve the impact of the DA on patient education and decision-making, ensuring its continued use in routine care.
期刊介绍：
Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press.
Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.
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