title: General practitioners' attitudes and preparedness towards Clinical Decision Support in e-Prescribing (CDS-eP) adoption in the West of Ireland: a cross sectional study.
abstract: BACKGROUND
  Electronic clinical decision support (CDS) is increasingly establishing its role in evidence-based clinical practice. Considerable evidence supports its enhancement of efficiency in e-Prescribing, but some controversy remains. This study evaluated the practicality and identified the perceived benefits of, and barriers to, its future adoption in the West of Ireland.
  
  
  METHODS
  This cross sectional study was carried out by means of a 27-part questionnaire sent to 262 registered general practitioners in Counties Galway, Mayo and Roscommon. The survey domains encompassed general information of individual's practice, current use of CDS and the practitioner's attitudes towards adoption of CDS-eP. Descriptive and inferential analyses were performed to analyse the data collected.
  
  
  RESULTS
  The overall response rate was 37%. Nearly 92% of respondents employed electronic medical records in their practice. The majority acknowledged the value of electronic CDS in improving prescribing quality (71%) and reducing prescribing errors (84%). Despite a high degree of unfamiliarity (73%), the practitioners were open to the use of CDS-eP (94%) and willing to invest greater resources for its implementation (62%). Lack of a strategic implementation plan (78%) is the main perceived barrier to the incorporation of CDS-eP into clinical practice, followed by i) lack of financial incentives (70%), ii) lack of standardized product software (61%), iii) high sensitivity of drug-drug interaction or medication allergy markers (46%), iv) concern about overriding physicians' prescribing decisions(44%) and v) lack of convincing evidence on the systems' effectiveness (22%).
  
  
  CONCLUSIONS
  Despite favourable attitudes towards the adoption of CDS-eP, multiple perceived barriers impede its incorporation into clinical practice. These merit further exploration, taking into consideration the structure of the Irish primary health care system, before CDS-eP can be recommended for routine clinical use in the West of Ireland.
authors.affiliation: Department of Medicine, National University of Ireland, Galway, Clinical Science Institute, Galway, Ireland.
authors.forename: Chee Peng
authors.initials: CP
authors.lastname: Hor
authors.forename: James M
authors.initials: JM
authors.lastname: O'Donnell
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Murphy
authors.forename: Timothy
authors.initials: T
authors.lastname: O'Brien
authors.forename: Thomas J B
authors.initials: TJ
authors.lastname: Kropmans
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D004059:Diffusion of Innovation; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D055695:Electronic Prescribing; D006284:Health Plan Implementation; D006801:Humans; D007494:Ireland; D010821:Physicians, Family / Q000523:psychology* / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires