The effectiveness of written communication for decision support in clinical practice

Abstract

Background: The application of various tools suggests limitations in the usage of drug information provided to medical professionals. Concurrent views of utility and suggested improvements for written information by health care practitioners are lacking.

Objective: This study's objectives were to: (1) assess practice-based perspectives on the relative efficacy and utility of different medication-related written materials for health care practitioners, (2) discern aspects of written communications that are valued for actionable information and merit health care practitioners' attention, (3) determine common or unique themes of clinicians practicing as physicians, pharmacists, physician assistants, and nurses regarding medication-related written information; and (4) organize constructs and themes as a cogent array of current deficiencies in written communications to guide improvements.

Methods: Two focus group panels (physicians, physician assistants, pharmacists, nurses) were convened to address clinical decisional balance and the utility of written information about medicines in assisting them with those decisions. A facilitated dialogue followed a semi-structured interview guide including overarching questions and tap-root probes derived from the literature. Comparative analyses were used to interpret data. An a priori coding framework informed the interview guide and served as a basis for initial identification of themes.

Results: Panelists from diverse practices and settings voiced convergent agreement on the limited utility of written materials, attributed primarily to current structure, formatting, content, and design. Recommendations thematically supported the need for greater accuracy, recency, adaptability, sequencing, and accessibility of information in formats more frequently digitalized.

Conclusions: Focus group panels of practitioners provided rich information on how current written information such as Dear Doctor letters and package inserts could be improved to facilitate real-time decision-making. Overall, improvements could contribute to an improved capacity for efficient, effective, and sustained evidence-based practice behavior.

Keywords: Clinical judgment; Decision support; Decisional process; Evidence-based practice; Written medical information.