Chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), are increasing in Switzerland, affecting 6% and 2.5% of the population respectively. Their management results in significant economic costs and treatment effectiveness depends on personal, psychosocial and therapeutic factors, including the complexity of inhalation devices. Usage defects or treatment non-adherence have the impact of increasing economic and health costs. Furthermore, these devices have a notable environmental impact, with 900,000 MDI-type inhalers prescribed in 2020 in Switzerland, emitting the equivalent of 20,000 tons of CO2.
The prescription of inhalation devices must take into account patients' cognitive and physical capabilities, their understanding of the treatment, their preferences, as well as the healthcare professional's experience. Currently, no validated algorithm exists to guide this prescription by integrating these factors and favoring the least polluting devices.
Clinical decision support systems (CDSS) are promising tools to improve this process. These systems combine patient data with clinical knowledge to assist physicians. However, existing CDSS often lack consideration of the patient's overall situation and the environmental impact of devices.
This project aims to develop a specialized CDSS for prescribing inhalation devices for chronic respiratory diseases. The evaluation will focus on the acceptance of the CDSS by physicians and patients, identifying barriers and facilitators to its implementation.
The project objectives include: co-designing a CDSS prototype with an expert panel, analyzing barriers to CDSS implementation and acceptance, creating guidelines for widespread dissemination and implementation of the CDSS.
The expected results are improved prescriptions, better patient adherence, reduced environmental impact of devices, decreased complications and hospitalizations, improved patient quality of life, and reduced healthcare costs.