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Clinicians’ experiences of using and implementing a medical mobile phone app (QUiPP V2) designed to predict the risk of preterm birth and aid clinical decision making

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article number320
JournalBMC medical informatics and decision making
Volume21
Issue number1
DOIs
Accepted/In press3 Nov 2021
Published18 Nov 2021

Bibliographical note

Funding Information: The development of the QUiPP app and the EQUIPTT study are funded by the Guy’s and St Thomas’ Charity (Registered Charity No. 1160316) and Tommy’s (1060508). As it is a portfolio study, recruitment is supported through local Clinical Research Networks. King’s College London and Guy’s and St Thomas’ NHS Foundation Trust are co-sponsors of the study but neither sponsor provided funding for the trial. The development of the QUiPP app and the EQUIPTT study are funded by the Guy’s and St Thomas’ Charity (Registered Charity No. 1160316) and Tommy’s (1060508). This work is supported by the clinical research network led by South London, the Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. HW is funded by a Guy’s and St Thomas’ NHS Trust Biomedical Research Centre Clinical Training Fellowship. PTS is partly funded by Tommy’s (Registered Charity No. 1060508) and by NIHR Applied Research Collaboration South London (NIHR ARC South London). JC was funded by the National Institute for Health Research’s NIHR/HEE CAT Clinical Doctoral Research Fellowship Programme (Ref. CDRF-2013-04-026). JS is an NIHR Senior Investigator and supported ARC by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. AHS and RMT receive funding from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2021, The Author(s).

King's Authors

Abstract

Abstract: Background: As the vast majority of women who present in threatened preterm labour (TPTL) will not deliver early, clinicians need to balance the risks of over-medicalising the majority of women, against the potential risk of preterm delivery for those discharged home. The QUiPP app is a free, validated app which can support clinical decision-making as it produces individualised risks of delivery within relevant timeframes. Recent evidence has highlighted that clinicians would welcome a decision-support tool that accurately predicts preterm birth. Methods: Qualitative interviews were undertaken as part of the EQUIPTT study (The Evaluation of the QUiPP app for Triage and Transfer) (REC: 17/LO/1802) which aimed to evaluate the impact of the QUiPP app on management of TPTL. Individual semi-structured telephone interviews were used to explore clinicians’ (obstetricians’ and midwives’) experiences of using the QUiPP app and how it was implemented at their hospital sites. Thematic analysis was chosen to explore the meaning of the data, through a framework approach. Results: Nineteen participants from 10 hospital sites in England took part. Data analysis revealed three overarching themes which were: ‘experience of using the app’, ‘how QUiPP risk changes practice’ and ‘successfully adopting QUiPP: context is everything’. With these final themes we appeared to have achieved our aim of exploring the clinicians’ experiences of using and implementing the QUiPP app. Conclusion: This study explored different clinician’s experiences of implementing the app. The organizational and cultural context at different sites appeared to have a large impact on how well the QUiPP app was implemented. Future work needs to be undertaken to understand how best to embed the intervention within different settings. This will inform scale up of QUiPP app use across the UK and ensure that clinicians have access to this free, easy-to-use tool which can positively aid clinical decision making when caring for women in TPTL. Clinical trial registry and registration number: ISRCTN 17846337, registered 08th January 2018, https://doi.org/10.1186/ISRCTN17846337.

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