The following is a summary of “Barriers and facilitators to using a clinical decision support tool for the management of osteoarthritis pain in patients undergoing hemodialysis: a qualitative study,” published in the August 2024 issue of Primary Care by Mohsen et al.

Osteoarthritis is a prevalent issue among patients undergoing hemodialysis, significantly impacting their quality of life. However, pain management for osteoarthritis in this population still needs to be improved due to a lack of tailored clinical guidance. This study investigated healthcare professionals’ (HCPs) perceptions regarding the barriers and facilitators to implementing a clinical decision support tool for managing osteoarthritis pain in hemodialysis.

A qualitative descriptive study was conducted utilizing purposeful and snowball sampling techniques to recruit hemodialysis clinicians from academic and community settings across multiple Canadian provinces. In-depth, one-to-one interviews were performed using a semi-structured, open-ended interview guide based on the Theoretical Domains Framework, a recognized behavior change model. Thematic analysis was applied using a general inductive approach to identify key barriers and facilitators related to using the clinical decision support tool.

The study included 11 interviews with three nephrologists, two nurse practitioners, and six pharmacists. Analysis revealed six primary barriers and facilitators. A significant barrier and facilitator was the alignment of the tool with clinicians’ practice roles. Additional barriers identified were challenges specific to the dialysis environment, varying levels of clinician comfort with prescribing pain medications, and limited tool applicability due to patient-specific factors. Conversely, a significant facilitator was the intrinsic motivation of clinicians to utilize the tool, reflecting their commitment to improving patient care.

Participants across the hemodialysis settings generally expressed satisfaction with the clinical decision support tool and recognized its potential to enhance osteoarthritis pain management in patients undergoing hemodialysis. However, the tool’s implementation may need to be improved related to established roles and practices within different institutions. Enhancing collaboration between hemodialysis and primary care teams could facilitate the broader adoption of the tool, potentially improving pain management outcomes for this patient population.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02564-5