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The effect of electronic audit and feedback in primary care and factors facilitating effectiveness: a systematic review.
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  • Steve Van den Bulck,
  • David Spitaels,
  • Bert Vaes,
  • Geert Goderis,
  • Rosella Hermens,
  • Patrik Vankrunkelsven
Steve Van den Bulck
KU Leuven Academic Center for General Practice
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David Spitaels
KU Leuven Academic Center for General Practice
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Bert Vaes
KU Leuven Academic Center for General Practice
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Geert Goderis
KU Leuven Academic Center for General Practice
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Rosella Hermens
KU Leuven Academic Center for General Practice
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Patrik Vankrunkelsven
KU Leuven Academic Center for General Practice
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Abstract

Rationale, aims and objectives: Little is known about the effect of electronic audit and feedback (A&F) in primary care and its features affecting intervention effectiveness. The aim of this systematic review is: 1) to assess electronic A&F’s effectiveness in primary care and 2) to investigate facilitating factors of electronic A&F in primary care, as proposed in previous research. These factors are the use of benchmarks, frequency, cognitive load and evidence-based aspect of the feedback. Methods: The authors searched MEDLINE, Embase, CINAHL and CENTRAL from 2010 onwards by replicating the search strategy provided in the last Cochrane review on A&F. Two independent reviewers assessed the records for their eligibility, performed the data extraction and evaluated the risk of bias of the included studies using a tool provided by Cochrane. Results: Our search resulted in 8,744 records, including the 140 RCTs from the last Cochrane Review, of which 431 full-text articles were assessed for their eligibility. Twenty-nine articles were included, of which 22 studies (76%) showed an effect of the electronic A&F intervention. Of these, only 3 studies (10.5%), targeting the quality of diabetes care and the prescription of antibiotics by dentist & physicians, met all the investigated feedback features and were effective. There was a high heterogeneity in the results and the design of the A&F interventions, causing a meta-analysis to be unreliable. Conclusion: This systematic review included 29 articles describing an electronic A&F intervention in primary care, of which 22 studies (76%) showed an effect of the intervention. It was not feasible to compare the different electronic A&F interventions and their facilitating factors because they were designed and implemented very diversely. Developing a framework or methodology for automated A&F interventions in primary care could be useful for investigating future interventions although further research is necessary.

Peer review status:UNDER REVIEW

27 Dec 2019Submitted to Journal of Evaluation in Clinical Practice
10 Jan 2020Assigned to Editor
10 Jan 2020Submission Checks Completed
12 Jan 2020Reviewer(s) Assigned
19 Feb 2020Review(s) Completed, Editorial Evaluation Pending