Feasibility Study of a Patient-centered CDS for Recommended Screenings in Primary Care

Condition(s) studied

Investigational drug(s) / intervention(s)

ADER-F quantitative assessment: The Lianeli SADM is designed to facilitate the identification of patients eligible for screenings recommended by the HAS (French National Authority for Health) and to facilitate shared decision-making during a primary care consultation dedicated to prevention. The Lianeli SADM will be used by the patient first via a health questionnaire, then by the patient and the general practitioner during the consultation dedicated to prevention.

Individual semi directive interview with the patient: 24 Semi-structured individual interviews will be conducted with a sample of volunteer patients, one month after the end of their follow-up, by a psychologist specializing in qualitative studies. The objective is to describe qualitatively the feasibility criteria for implementing the intervention according to the GUIDES checklist domains (A favorable context of use, appropriate content, a high-performance system, adequate implementation)

Individual semi directive interview or r Focus Group with the primary care professional: Semi-structured individual interviews or focus groups with 24 primary care professionals will be conducted by a psychologist specializing in qualitative studies with a sample of volunteers, one month after the last patient's last visit to the center. The objective is to describe qualitatively the feasibility criteria for implementing the intervention according to the GUIDES checklist domains (A favorable context of use, appropriate content, a high-performance system, adequate implementation)

Study summary

Primary care professionals (PCPs) are responsible for identifying patients who are eligible for all recommended screenings. Eligibility is difficult, given the number of screenings recommended by the French National Authority for Health (HAS), and the complexity of defining risk groups. When eligibility for one or more screenings is identified, the PCP informs the patient and can help him or her make the decision, considering his or her values and preferences.

Lack of information for patients and lack of time for PCPs are the main obstacles to prevention in primary care (PC). Another barrier identified is the lack of opportunity for patients who do not consult their PCP very often, as they are less likely to be approached for preventive interventions due to other more urgent reasons for consultation.

A Medical Decision Support System (MDSS) is a software application designed to be a direct aid to clinical decision-making, in which an inference engine matches individual patient characteristics with a computerized knowledge base or machine-learning algorithm to propose a risk assessment or adapted recommendations to the healthcare professional and/or patient.

The aim of the ADER-F research program is to support the development and evaluation of a complex intervention centred on the use of a MDSS called "Lianeli".

This complex intervention will ultimately contribute to structuring new consultations dedicated to prevention in general practice, by improving the physician's sense of self-efficacy in conducting the shared screening decision, and reducing the patient's decision-making conflict.

Eligibility

Primary outcome measure(s)

• Lianeli SADM fully used — Within 60 days of the inclusion consultation
  The primary outcome is a composite criterion. This composite criterion is the proportion of patients with full use of the Lianeli SADM. A "yes" answer to the three following items defines full use of the Lianeli SADM: * Validation by the patient of their answers to the Lianeli health questionnaire (yes/no) * Validation by the general practitioner of the patient's responses to the Lianeli health questionnaire (yes/no) * Completion of the consultation dedicated to screening (yes/no)
• Lianeli SADM fully used — Within 60 days of the inclusion consultation
  Proportion of patients included for whom the Lianeli SADM was fully used : Verification of the questionnaire by the GP (validate/not validated)
• Lianeli SADM fully used — Within 60 days of the inclusion consultation
  Proportion of patients included for whom the Lianeli SADM was fully used : Dedicated screening consultation with the GP (done/not done)

Trial sites (20)

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