A Survey of Primary Care Clinician Experiences With Electronic Health Record-Based Clinical Decision Support to Improve HIV Pre-Exposure Prophylaxis Prescribing
Clinical Snapshot
PICO Framework
| P — Population | Primary care clinicians using electronic health record systems |
| I — Intervention | Electronic health record-based clinical decision support tool for HIV pre-exposure prophylaxis |
| C — Comparator | Not applicable (descriptive survey study) |
| O — Outcomes | Clinician experiences, perceived appropriateness, usefulness, workflow barriers, and usability of the clinical decision support tool |
Bottom Line
This survey study suggests that electronic health record-based clinical decision support tools for HIV pre-exposure prophylaxis can be perceived as appropriate and useful by primary care clinicians for identifying at-risk patients. However, implementation success appears to be significantly limited by workflow integration challenges and usability barriers. The findings underscore the critical importance of incorporating clinician feedback during post-implementation phases to optimize clinical decision support tool effectiveness. While the study addresses an important clinical implementation question relevant to HIV prevention efforts, the limited methodological detail available makes it difficult to fully assess the validity and generalisability of these findings. Australian primary care practices considering similar EHR-based HIV PrEP decision support tools should prioritise workflow integration and usability testing, particularly given differences in practice patterns and electronic health record systems compared to the US healthcare setting studied.
Key Findings
P Value: Not reported
Effect Size: Not quantified - described as 'appropriate and useful'
Primary Outcome: Clinician perceptions of clinical decision support tool appropriateness and usefulness
Nnt Or Sensitivity: Not applicable for this descriptive study
Confidence Interval: Not reported
Clinical Application
Moderate - requires EHR integration and clinician training, with attention to workflow optimization Relevant to Australian primary care given increasing focus on HIV PrEP implementation through PBS listing and RACGP guidelines, though workflow differences may exist Primary care clinicians implementing HIV PrEP programs with electronic health record systems
Abstract
A survey of primary care clinicians suggests that a clinical decision support tool to support sexual risk assessment and prescribing of HIV pre-exposure prophylaxis was appropriate and useful for identifying at-risk patients, but uptake was hindered by workflow and usability barriers, which underscores the importance of postimplementation clinician feedback to improve the use of clinical decision support tools.
References
- 1.Agovi, A. M., Thompson, C. T., Li, W., Allard, J., Lee, N., Fasanmi, E., & Ojha, R. P. (2026). A Survey of Primary Care Clinician Experiences With Electronic Health Record-Based Clinical Decision Support to Improve HIV Pre-Exposure Prophylaxis Prescribing. JMIR Formative Research. https://doi.org/10.2196/89638
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