The following is a summary of “Clinical Decision Support Systems for Palliative Care Management: A Scoping Review,” published in the March 2023 issue of Pain Management by Santos, et al.
As palliative care services expand in clinical settings, clinical decision support systems (CDSSs) have become increasingly important in assisting bedside nurses and other clinicians in providing high-quality care to patients with life-limiting health conditions. For a study, researchers sought to characterize palliative care CDSSs and explore end-users actions, adherence to recommendations, and clinical decision time.
A systematic search was conducted in the CINAHL, Embase, and PubMed databases from inception to September 2022. The review followed the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines. The included studies were summarized in tables, and their level of evidence was assessed.
Out of 284 abstracts screened, 12 studies were included in the final sample. The selected 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. Despite variations in palliative CDSSs, all studies reported that CDSSs helped clinicians become more informed about palliative care options, leading to improved decision-making and patient outcomes. Seven studies examined the impact of CDSSs on end-user adherence, with three reporting high adherence to recommendations and four reporting low adherence. The lack of feature customization and initial trust in guideline-based approaches during feasibility and usability testing limited the usefulness for nurses and other clinicians.
Implementing palliative care CDSSs can assist nurses and other clinicians in providing higher-quality care for palliative patients. However, the variability in methodologies and CDSS designs across the studies made comparing and validating their effectiveness challenging. Further research with rigorous evaluation methods was recommended to assess the impact of CDSS features and guideline-based actions on clinicians’ adherence and efficiency.
Source: jpsmjournal.com/article/S0885-3924(23)00423-2/fulltext
