Testing a prototype clinical decision support tool for the management of male LUTS
Problem
Lower urinary tract symptoms (LUTS) are common amongst men as they get older, and can have a considerable impact on quality of life. Although in most cases LUTS could be treated in primary care - benefitting the patient and reducing NHS costs - referrals to urology specialists are increasing. Management can be complex, and GPs currently do not have access to a simple tool to support diagnosis. Therefore, the National Institute for Health Research (NIHR) released a 2015 Health Technology Assessment (HTA) commissioned call for the development of a decision aid to help inform treatment choice or need for specialist referral for men presenting with LUTS in primary care. The PriMUS study was funded to address this brief and has resulted in the development of a prototype clinical decision support tool. A qualitative user-testing study has been conducted, aiming to gather feedback from GPs to inform future development of the tool.
Approach
GPs involved in the PriMUS study were invited to test the online prototype tool using fictional patient data, and provide feedback via a brief telephone interview. Interviews were conducted with 10 GPs, who were asked for their views on the content, design and usability of the tool. All interviews were audio-recorded, transcribed verbatim and thematically analysed.
Findings
GPs found that the tool had a user-friendly design and layout. The management recommendations generated were considered helpful and straightforward to follow. GPs reported that the tool would be useful in practice and had the potential to reduce urology referrals. They suggested that it could be used to facilitate greater patient involvement, as it provided useful visual displays of likely diagnoses and management recommendations. Several recommendations were made for the future development of the tool, for example that it should be integrated into the clinical system, provide links to printable patient advice leaflets, and give specific examples of medications to try.
Consequences
Findings generated useful, specific recommendations for the future development of the clinical decision support tool, which have the potential to increase its uptake and usability, and in turn improve the management of male LUTS in primary care.