How to optimise the implementation of a computerised decision-support tool for knee osteoarthritis in Belgian general practice?




Poster session 3 Friday: Evidence Tools / Evidence synthesis - creation, publication and updating in the digital age


Friday 15 September 2017 - 12:30 to 14:00


All authors in correct order:

Spitaels D1, Van de Velde S2, Vankrunkelsven P1
1 Academic Center of General Practice, KU Leuven, Belgium, Belgium
2 Norwegian Institute of Public Health, Oslo, Norway, Norway
Presenting author and contact person

Presenting author:

Patrik Vankrunkelsven

Contact person:

Abstract text
Background: In Belgium, healthcare professionals have free access to an evidence-based database, called EBMPracticeNET, with more than a 1000 international guidelines validated for the Belgian healthcare professionals. This portal can also be used to generate computerised decision support (CDS) in the Electronic Health Records (EHR) of GPs. To date, the evidence on the effect of CDS on patient outcomes is very uncertain. Therefore, we develop a new CDS tool that involves diagnostic approach and management of knee osteoarthritis. Knee osteoarthritis was chosen as a topic, because it is one of the most common musculoskeletal diseases and its economic impact is similar to that of coronary heart disease.

Objectives: The objective of this study is to enhance the feasibility of a new CDS tool for knee osteoarthritis in general practice by performing an extensive pilot before implementing the tool.

Methods: We will conduct a multi-phased pilot prior to a multi-centre, cluster-randomised trial. In this trial GP practices will be randomly assigned to receive the CDS intervention or to follow the usual care in a 1:1 ratio. Before the start of the intervention we will: 1) conduct in-depth semi-structured mixed interviews with GPs and patients; 2) integrate the knee osteoarthritis algorithms in the portals for CDS; 3) pilot-test the CDS intervention for implementation readiness; 4) developing an e-learning intervention for GPs; 5) ask the participating GPs to perform a computerised search in their EHR to identify any existing knee osteoarthritis patients; and, 6) perform a nested study by interrupted time series to follow the number of patients having a codified knee osteoarthritis from three months prior to the trial.

Conclusions: GPs and patients perception on knee osteoarthritis and decision support could play an important role in improving the feasibility of this new CDS tool.