scholarly journals “Quality of prenatal and maternal care: bridging the know-do gap” (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan Africa

Author(s):  
Antje Blank ◽  
Helen Prytherch ◽  
Jens Kaltschmidt ◽  
Andreas Krings ◽  
Felix Sukums ◽  
...  
2019 ◽  
Vol 35 (S1) ◽  
pp. 83-83
Author(s):  
Noemí Robles ◽  
Carme Carrion i Ribas ◽  
Marta Aymerich

IntroductionE-health offers the opportunity of supporting the management of several diseases, but most of these tools are far from being based on scientific evidence and demonstrating their effectiveness and efficacy. The PSICODEM Project aims to develop a mobile personalized clinical decision support system (CDSS) based on evidence for contributing to e-health interventions addressed to the management of dementia that require not only a pharmacological approach but also psychosocial interventions for improving patients’ quality of life and reducing emotional, cognitive and behavioral symptoms. The present communication focuses on the identification of the evidence on which the CDSS algorithm will be developed.MethodsThree systematic reviews were carried out in order to identify the existing scientific evidence published in relation to the effectiveness of behavioral, emotional and cognitive therapies addressing dementia (January 2009 to December 2017). The main databases were consulted (PubMed, Cochrane Library, PsychoInfo) and only randomized control trials (RCT) were considered. Articles were reviewed by two independent reviewers. The quality of the selected publications was assessed according to the SIGN criteria.ResultsForty-seven RCTs were selected for cognitive therapies, thirty-two for emotional ones and fifteen for behavioral interventions. Those therapies with more support of evidence were skills training for cognitive therapies and reminiscence interventions for emotional interventions; however, in behavioral interventions a variety of therapeutically approaches were found. Wide differences were found between studies in terms of types and levels of dementia, forms of intervention (number, length and frequency of sessions) and outcome measures.ConclusionsIn-depth analysis of evidence will allow the identification of those interventions more appropriate for each patient according to their symptoms and level of dementia. According to this evidence, the mobile CDSS algorithm will be developed. Additionally, these findings point out the gaps in psychosocial intervention research.


2020 ◽  
Vol 44 (10) ◽  
Author(s):  
David L. Chin ◽  
Michelle H. Wilson ◽  
Ashley S. Trask ◽  
Victoria T. Johnson ◽  
Brittanie I. Neaves ◽  
...  

Author(s):  
Sidagna Alphonse Zakane ◽  
Lars L Gustafsson ◽  
Ali Sie ◽  
Göran Tomson ◽  
Svetla Loukanova ◽  
...  

AbstractObjective:  Maternal and neonatal mortality is high in sub-Saharan Africa. To support Healthcare Workers (HCWs), a computerized decision support system (CDSS) was piloted at six rural maternal care units in Burkina Faso. During the two years of the study period, it was apparent from reports that the CDSS was not used regularly in clinical practice. This study aimed to explore the reasons why HCWs failed to use the CDSS.Methods: A workshop, organised as group discussions and a plenary session, was performed with 13 participants to understand their experience with the CDSS and suggest improvements if pertinent. Workshop transcripts were analysed thematically. Socio-demographic and usage patterns of the CDSS were examined by a questionnaire and analysed descriptively.Results: The participants reported that the contextual basic conditions for using the CDSS were not fulfilled. These included unreliable power supply, none user-friendly partograph, the CDSS was not integrated with workflow and staff lacked motivational incentives. Despite these limitations, the HCWs reported learning benefits from guidance and alerts in the CDSS. Using the CDSS enabled them to discover problems earlier as they learned to focus on symptoms to prevent harmful situations.Conclusion: The CDSS was not tailored to the needs and context of the users. The HCWs, defined their needs and suggested how the CDSS should be re-designed. This suggests that the successful and regular usage of any CDSS in rural settings requires the involvement of users throughout the construction and pilot-testing phases and not only during the early prototype design period.


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