Physicians’ views on using an electronic health record calculator to assess the risk of venous thromboembolism in hospitalized patients: a qualitative study

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TH open. 2022 Jan 24;6(1):e33-e39. doi: 10.1055/s-0041-1742227. eCollection 2022 Jan.

ABSTRACT

Fund Venous thromboembolism (VTE) causes preventable hospital morbidity. Pharmacological prophylaxis reduces VTE in patients at risk, but also increases bleeding. To increase appropriate prescribing, a risk calculator to guide prophylaxis decisions was developed. Despite efforts to promote its use, vendors have rarely had access to it. Goal This study aimed to understand providers’ perspectives on VTE prophylaxis as well as facilitators and barriers to using the risk calculator. Design This is a qualitative study exploring providers’ perspectives on VTE prophylaxis and the VTE risk calculator. Speakers We interviewed referring physicians and advanced practice providers who used the calculator, as well as site champions who promoted calculator use. Providers were ranked by actual usage over a 3-month period: low (50%). Approach In semi-structured interviews, we asked about experiences with VTE, use of the calculator, perspectives on its implementation, and experiences with other risk assessment tools. Once thematic saturation was reached, the transcripts were analyzed using content analysis to identify themes. Results Fourteen suppliers participated. Five were heavy users, three were moderate users, and six were light users. Three site champions participated. Eight major themes were identified as follows: (1) ease of use, (2) perception of VTE risk, (3) harms of thromboprophylaxis, (4) overestimation of calculator use, (5) trust own ability, (6) underestimation of risk by calculator, (7) variability in confidence in calculator, and (8) validation to deny prophylaxis to low-risk patients. conclusion Although providers found the calculator easy to use, routine use may be hampered by distrust of its recommendations. Inaccurate perception of VTE and bleeding risk may preclude the use of the calculator.

PMID:35088025 | PMC:PMC8786561 | DOI:10.1055/s-0041-1742227

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