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dc.contributor.authorKunstler, BE
dc.contributor.authorFurler, J
dc.contributor.authorHolmes-Truscott, E
dc.contributor.authorMcLachlan, H
dc.contributor.authorBoyle, D
dc.contributor.authorLo, S
dc.contributor.authorSpeight, J
dc.contributor.authorO'Neal, D
dc.contributor.authorAudehm, R
dc.contributor.authorKilov, G
dc.contributor.authorManski-Nankervis, J-A
dc.date.accessioned2020-11-17T03:30:25Z
dc.date.available2020-11-17T03:30:25Z
dc.date.issued2020-09-02
dc.identifierpii: v4i9e17785
dc.identifier.citationKunstler, B. E., Furler, J., Holmes-Truscott, E., McLachlan, H., Boyle, D., Lo, S., Speight, J., O'Neal, D., Audehm, R., Kilov, G. & Manski-Nankervis, J. -A. (2020). Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record.. JMIR Form Res, 4 (9), pp.e17785-. https://doi.org/10.2196/17785.
dc.identifier.issn2561-326X
dc.identifier.urihttp://hdl.handle.net/11343/251522
dc.description.abstractBACKGROUND: Managing type 2 diabetes (T2D) requires progressive lifestyle changes and, sometimes, pharmacological treatment intensification. General practitioners (GPs) are integral to this process but can find pharmacological treatment intensification challenging because of the complexity of continually emerging treatment options. OBJECTIVE: This study aimed to use a co-design method to develop and pretest a clinical decision support (CDS) tool prototype (GlycASSIST) embedded within an electronic medical record, which uses evidence-based guidelines to provide GPs and people with T2D with recommendations for setting glycated hemoglobin (HbA1c) targets and intensifying treatment together in real time in consultations. METHODS: The literature on T2D-related CDS tools informed the initial GlycASSIST design. A two-part co-design method was then used. Initial feedback was sought via interviews and focus groups with clinicians (4 GPs, 5 endocrinologists, and 3 diabetes educators) and 6 people with T2D. Following refinements, 8 GPs participated in mock consultations in which they had access to GlycASSIST. Six people with T2D viewed a similar mock consultation. Participants provided feedback on the functionality of GlycASSIST and its role in supporting shared decision making (SDM) and treatment intensification. RESULTS: Clinicians and people with T2D believed that GlycASSIST could support SDM (although this was not always observed in the mock consultations) and individualized treatment intensification. They recommended that GlycASSIST includes less information while maintaining relevance and credibility and using graphs and colors to enhance visual appeal. Maintaining clinical autonomy was important to GPs, as they wanted the capacity to override GlycASSIST's recommendations when appropriate. Clinicians requested easier screen navigation and greater prescribing guidance and capabilities. CONCLUSIONS: GlycASSIST was perceived to achieve its purpose of facilitating treatment intensification and was acceptable to people with T2D and GPs. The GlycASSIST prototype is being refined based on these findings to prepare for quantitative evaluation.
dc.languageeng
dc.publisherJMIR Publications Inc.
dc.titleGuiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record.
dc.typeJournal Article
dc.identifier.doi10.2196/17785
melbourne.affiliation.departmentGeneral Practice
melbourne.affiliation.departmentMedicine and Radiology
melbourne.source.titleJmir Formative Research
melbourne.source.volume4
melbourne.source.issue9
melbourne.source.pagese17785-
dc.rights.licenseCC BY
melbourne.elementsid1459333
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC7495264
melbourne.contributor.authorBoyle, Douglas
melbourne.contributor.authorFurler, John
melbourne.contributor.authorO'Neal, David
melbourne.contributor.authorAudehm, Ralph
melbourne.contributor.authorManski-Nankervis, Jo-Anne
melbourne.contributor.authorKunstler, Breanne
dc.identifier.eissn2561-326X
pubs.acceptance.date2020-07-26
melbourne.accessrightsOpen Access


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