Clinical Decision Support Improves Quality Of Care In Patients With Ulcerative Colitis

Jackson, B, Begun, J, Gray, K, Churilov, L, Knowles, S, Wong, J and De Cruz, P 2019, 'Clinical Decision Support Improves Quality Of Care In Patients With Ulcerative Colitis', Alimentary Pharmacology and Therapeutics, vol. 49, no. 8, pp. 1040-1051.


Document type: Journal Article
Collection: Journal Articles

Title Clinical Decision Support Improves Quality Of Care In Patients With Ulcerative Colitis
Author(s) Jackson, B
Begun, J
Gray, K
Churilov, L
Knowles, S
Wong, J
De Cruz, P
Year 2019
Journal name Alimentary Pharmacology and Therapeutics
Volume number 49
Issue number 8
Start page 1040
End page 1051
Total pages 12
Publisher Wiley-Blackwell
Abstract Background Decision support tools may facilitate shared decision-making and improve quality of care. Aim To assess the effectiveness of a decision support tool on improving quality of care in ulcerative colitis. Methods A prospective quality of care intervention was conducted at two Australian hospitals comparing out-patient-based ulcerative colitis care with, and without, a tablet-based decision support tool. This included questions on disease activity management; psychological well-being; and preventive care, with 13 process indicators relevant to each domain. Participants included adult out-patients with mild-to-moderate ulcerative colitis and their clinicians who were divided into two cohorts. The first cohort were followed up immediately after their clinical review to check whether their clinician had discussed the 13 process indicators during the consultation. The second cohort of patients used the decision support tool immediately prior to their consultation which then generated a suggested management plan for the patient and clinician to discuss during the consultation. Management between the 2 cohorts was compared to assess the effectiveness of the decision support tool in improving the primary outcome, defined as the proportion of quality process indicators used for ulcerative colitis care, with and without the decision support tool. Results Thirteen physicians and 100 patients participated. Fifty patients were managed without the decision support tool using standard care (median age 40; 44% male), and 50 patients used the decision support tool (median age 40; 46% male) over a 20-week period. Increase in the median use of process indicators overall was observed following use of the decision support tool (27% vs 100%; P < 0.001). Improvements were seen in psychological well-being management (30% vs 100%; P < 0.001), preventive care (16% vs 100%; P < 0.001) and process indicators related to disease activity management (50% vs 100%; P < 0.001). The decision s
Subject Pharmacology and Pharmaceutical Sciences not elsewhere classified
Keyword(s) inflammatory-bowel-disease
interrupted time-series
depressive symptoms
management
anxiety
online
adults
state
DOI - identifier 10.1111/apt.15209
Copyright notice © 2019 John Wiley & Sons Ltd
ISSN 0269-2813
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