Clinical Decision Support Tool for Back Pain Earns High Marks From Pharmacists

An electronic clinical decision support system designed to guide pharmacists’ recommendations for patients with low back pain earned high ratings for usability and acceptance among pharmacists trying out the prototype, according to a study published online in JMIR Medical Informatics. 

“People with low back pain in the community often do not receive evidence-based advice and management. Community pharmacists can play an important role in supporting people with low back pain as pharmacists are easily accessible to provide first-line care,” researchers wrote. “However, previous research suggests that pharmacists may not consistently deliver advice that is concordant with guideline recommendations and may demonstrate difficulty determining which patients require prompt medical review.”

Australian researchers worked with academic and clinical experts to develop a tablet app designed to guide first-line care of low back pain in the community pharmacy setting. Five community pharmacists evaluated the prototype using five case vignettes role-played by a researcher.

Pharmacists rated the overall usability of the clinical decision support system prototype as good to excellent, the study found. Acceptance was also high of the system’s self-care recommendations (90%), medicine recommendations (100%), and referral recommendations (88%). 

However, pharmacists expressed uncertainty with the system’s guidance for screening for serious causes of low back pain. They also requested better direction from the interface for page navigation and automated prompts for user input.

The findings will help inform the next stage of system development, researchers noted. 

“This clinical decision support system has been designed to provide a unique opportunity for community pharmacists to provide simple, evidence-based advice for clients who present with low back pain,” they wrote. “Importantly, the clinical decision support system offers key messages of reassurance, to remain active, to use medicines appropriately, and to avoid inappropriate imaging.” 

—Jolynn Tumolo

Reference:

Downie AS, Hancock M, Abdel Shaheed C, et al. An Electronic Clinical Decision Support System for the Management of Low Back Pain in Community Pharmacy: Development and Mixed Methods Feasibility Study. JMIR Med Inform. 2020;8(5):e17203. Published 2020 May 11. doi:10.2196/17203