Alice Le Bonniec, Pierre-Yves Meunier, Julien Peron and Laurent LETRILLART
Development and evaluation of a primary care decision support system for recommended screenings.
Recommended screenings especially target cancers, cardio-metabolic conditions, infections, and psycho-social problems. There are simultaneously an insufficient coverage of the recommended screenings and a misuse of certain non-recommended screenings. A systematic review of barriers and facilitators found that the advice of health professionals and the quality of their communication with the patients have a strong influence on the participation to most recommended screenings. The identification of various modifiable determinants common across conditions highlights the potential of an integrated screening participation approach.
A systematic revue of barriers and facilitators to the use decision support systems in primary care has showed the interest of the systems including preventive care, covering a large array of conditions, providing personalized reminders and educational materials to patients. The Prevenear startup is developing the Lianeli digital support system for shared decision on the recommended screenings, based on an integrated and personalised approach. It includes an algorithm built from the analysis of the recommendations of the HAS (or otherwise of the USPSTF) by a multidisciplinary scientific committee.
This digital system will be evaluated in terms of feasibility and effectiveness. The feasibility study will measure the effective use of the system in usual general practice through a multicentre prospective study. The effectiveness study will measure a global index of participation to the recommended screenings through a cluster-randomised intervention trial.