Discussion
To the best of our knowledge, this is the first feasibility study on the use of a CDSS in the treatment of PI in patients with SCI. The prescriptions and therapies were carried out almost equally in both groups. Nevertheless, in the CDSS group, the prescriptions and therapies generally started earlier than in the control group. The use of the CDSS did not significantly improve clinical and economic outcomes during this observation period. All HCPs showed interest in the CDSS and a willingness to integrate it into their clinical routine. HCPs endorsed the CDSS as a way to improve the quality of patient care by integrating guideline recommendations, allowing individual adaptations, and supporting interdisciplinary and interprofessional treatment. However, technical difficulties and time-consuming tasks characterized the use of the CDSS, which hindered its use as an extra IT system.Different attitudes and principles between the clinical and the IT management group became apparent [The overall goal of this feasibility study, as part of a quality improvement project using a CDSS, was to optimize clinical processes and, consequently, clinical outcomes [The CDSS was judged as relevant and feasible by the HCPs [Although some participants showed a willingness to use the CDSS, we found that misunderstandings about the purpose of the CDSS contributed to resistance by others. HCPs were disappointed with the CDSS because they interpreted its use as part of a scientific study and not as a means to improve clinical management. This underlines the importance of effective communication with users to reduce misunderstandings and resistance in a pilot study as part of a quality improvement project [Although the CDSS demonstrated some advantages that could lead to future improvements in process-based clinical care, the decision regarding its implementation should be made carefully given the high investment in terms of costs and workload [