Considerable Care Research Articles

Abstract 4136975: Lipoprotein (a) Discovery Project: Assessing Patient and Professional Education Needs

Introduction: It is estimated that 1 in 5 Americans have high lipoprotein (a) [Lp(a)] levels. High levels of Lp(a) are an independent, predominantly inherited, and causal risk factor for atherosclerotic cardiovascular disease (ASCVD). More investigation is needed to better understand the gaps in both professional and patient education on Lp(a) and its associated risk with ASCVD. Goals: The American Heart Association (AHA) is implementing a national 3-year initiative called the Lp(a) Discovery Project to understand system-level practice patterns for patients screened for high Lp(a) and develop models for national education. We aim to gauge an understanding of healthcare professional (HCP) and patient awareness, perceptions, knowledge, and behaviors of Lp(a) to develop a comprehensive educational approach that ultimately encourages patient-provider shared decision-making. Methods: To assess patient education needs, an online survey was conducted from October 11 to November 6, 2023, by Harris Insights&Analytics LLC with a nationally representative sample of 3,006 U.S. adults 18 years+. To assess professional education needs, the AHA engaged 10 champions from diverse health systems with established Lp(a) screening processes and workflows to participate in a Learning Healthcare System model to share best practices, inform on models for Lp(a) screening, and provide input on professional education topics. Results: The patient survey revealed that 34% of adults do not perceive high Lp(a) to pose an increased risk of heart attack, peripheral artery disease or stroke. If told that high Lp(a) does increase this risk, 63% are motivated to have their Lp(a) level checked and 88% would be motivated to reduce their risk for these conditions if they had high Lp(a). Ultimately, HCP recommendation was the most significant driver in getting screened among those who had their Lp(a) measured (61%). AHA-led champion interviews revealed that primary and specialty care HCPs need education on the importance of Lp(a) testing and cascade screening for family members as well as care considerations for patients with high Lp(a). Conclusion: Given that patients are most likely to be screened for Lp(a) if their HCP recommends it, we will focus on 1) educating patients and HCPs on the connection between Lp(a) and risk for cardiovascular disease and stroke and 2) providing HCPs with guidance on care considerations for those with high Lp(a) including cascade screening.

Evidence-Informed Nursing Clinical Practices for Wound Debridement.

Debridement, a mainstay of nursing clinical practice, refers to the removal of dead or unhealthy tissue from a wound to facilitate healing. Debridement is one component of the concept of wound bed preparation that has long guided the approach to wound management. The ability of a wound to heal must be determined prior to the initiation of any method of debridement. In areas where high-quality, comparative studies on the relative benefits of different debridement modalities are lacking, nurses should adopt an evidence-informed approach to care. To do this, nurses must understand the importance of following a comprehensive, holistic approach when treating chronic wounds. Nurses should have knowledge of inflammation and infection control and of the fundamentals of moisture management, recognize the need for debridement in healable wounds, and be familiar with different debridement options. This article provides nurses with a wound management framework, an overview of wound debridement options based on the potential for wound healing, and scope of practice considerations for developing a plan of care. A composite case is presented to illustrate the critical considerations in wound care.

Faecal carriage of extended-spectrum beta-lactamase and carbapenemase-producing enterobacterales among HIV patients at Jimma Medical Center, Southwest Ethiopia

BackgroundEnterobacterales infections in immunocompromised individuals are associated with considerable morbidity, mortality, and health care costs. This study aimed to assess the faecal carriage of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing Enterobacterales (CPE) among HIV-infected patients at Jimma Medical Center. A total of 344 stool samples were collected and inoculated on Mac-Conkey and Eosin-Methylene Blue agar and incubated at 35–37 °C aerobically. ESBL and carbapenemase production were detected using D68C ESBL/AmpC and D73C CARBA plus (Mast Group, UK).ResultsA total of 376 Enterobacterales were isolated. The prevalence of ESBL-PE and CPE carriage rate was 13.3% (50/376) and 4.3% (16/376) respectively. The highest proportion of ESBL producing isolates were found in K. pneumoniae 29.0% (9/31) followed by E. coli 13.4% (39/292). Similarly, K. pneumoniae 12.9% (4/31) was the most common carbapenem-resistant isolate followed by E. coli 3.8% (11/292). Multi-drug resistance was observed in 66.5% (250/376) of the isolates. Prior cephalosporin use (AOR = 7.9; 2.31–27.29), CD4 count (≤ 350 cells/µL) (AOR = 3.8; 1.12–12.9), and comorbidities (AOR = 2.3; 1.24–4.32) were significantly associated with ESBL production. Additionally, cephalosporin use (AOR = 6.34; 1.27–31.66) was significantly associated with the presence of CRE.ConclusionsThis study revealed a high prevalence of ESBL-PE and CPE among HIV patients, with K. pneumoniae and E. coli being the dominant isolates. MDR was common, with key risk factors being prior cephalosporin use, low CD4 counts, and comorbidities. These findings emphasize the need for enhanced infection prevention and control, regular screening, and improved antibiotic stewardship to curb the spread of resistant bacteria in immunocompromised individuals.

Primary Care Considerations for Individuals With Duchenne Muscular Dystrophy

Duchenne muscular dystrophy (DMD) is an uncommon genetic neuromuscular condition manifesting as progressive and irreversible muscular weakness. It is usually diagnosed in childhood, and, unfortunately, individuals living with DMD have a shortened lifespan. DMD has an effect on multiple body systems, leading to complications such as cardiomyopathy, respiratory infections, fragility fractures, and mood disorders. Nurse practitioners working in the primary care setting are in a key position to support the individual by approaching the disease from a multisystem lens, incorporating preventive care to maximize health and well-being at varying stages of the disease process.

A Blended Learning Approach to Teaching Medication Use and Perspectives on Spiritualty in Pharmacy Practice

ObjectiveTo assess students’ performance and perspective on the role of spirituality in pharmacy practice utilizing a blended learning approach. MethodsStudents viewed online pre-class videos on general spirituality and five major religions in the United States. Next, students attended an interactive lecture followed by a simulated counseling session. Lastly, students completed an anonymous, 38-question, electronic perspective survey. The items were grouped into scales results and compared using paired-sample t-tests. Effects sizes were measured by Cohen’s d. Additionally, students could opt to complete a reflection assignment on this activity as part of a concurrent course. A content analysis qualitative approach was utilized to assess these reflections. ResultsAll students (n=125) completed the counseling session, and 113 (90.4%) completed the survey. The mean score on the counseling session rubric was 94.8%, demonstrating students’ skills in recognizing spiritual concerns utilizing simulated patients.All perspective scale scores indicated a statistically significant change from pre to post, with the greatest change demonstrated in empathic perspective-taking (medium effect), followed by anxiety and lack of multicultural self-efficacy, religious/spiritual openness, and desire to learn (small effects). Students agreed that the instruction helped prepare them as a pharmacist (mean=5.41) and it was valuable hearing from people with authentic experiences (mean=5.40). Major learning themes included individualizing care, respect for beliefs, learning about diverse backgrounds, and prohibited medications. ConclusionsStudents performed well utilizing a blended learning approach on counseling patients regarding medication-related spiritual needs. In addition, the students perceived an increase in empathy while addressing spiritual considerations in patient care.

The Integration of Robotics in Proactive Healthcare: Embracing Proactive Medicine for Enhanced Patient Care and Ethical Considerations

The Integration of Robotics in Proactive Healthcare: Embracing Proactive Medicine for Enhanced Patient Care and Ethical Considerations

Influence of urban noise exposure on early-onset myocardial infarction risk prediction

Abstract Results from the DECIBEL-MI (Determination of Environmental CIty-noise's Burden, Exposure, and Link to Myocardial Infarction) Study Background Urban noise has not been incorporated into existing risk scores for cardiovascular events. The present study endeavors to explore the impact of noise exposure on the individual risk of early-onset myocardial infarction (MI). Methods All consecutive patients aged ≤ 50 years with acute MI who were admitted to a heart center between 2015 and 2023 and were residing in our city were included. The LIFE-CVD model was used to predict the 10-year cardiovascular risk of the patients based on traditional risk factors at the time of MI. The Geoportal Bremen was used to calculate both the daytime (Lden) and nighttime (Lnight) residential noise exposure levels. Results Among the 430 patients aged 50 years or younger diagnosed with MI, an elevated incidence of noise exposure compared to the general population in the same region was observed. This result was observed in both Lden (65% vs. 53%, p < 0.01) and Lnight (55% vs. 41%, p < 0.01). Patients with MI and a low LIFE-CVD score (≤2.5%) exhibited significantly higher noise exposure in comparison to those with a high LIFE-CVD score (2.32 vs. 1.36, p < 0.01 for Lden, and 1.72 vs. 1.00, p < 0.01 for Lnight). The average noise exposure increased with decreasing traditional risk factors exposure (see Figure 1). This inverse relationship persisted significantly in a linear regression analysis, even after adjusting for potential confounding factors such as socioeconomic status, PM10 and renal function (p < 0.01). Consequently, the incorporation of urban noise exposure contributes to optimizing the stratification of risk groups within LIFE-CVD risk categories. Conclusion Young patients with myocardial infarction (MI) who had fewer traditional risk factors were exposed to higher noise levels. Through comprehensive multivariate analysis, we identified a consistent inverse association between residential noise and the estimated cardiovascular risk based on traditional risk factors. Incorporating noise exposure into clinical care considerations has the potential to enhance the accuracy of MI prediction. Figure 1: Comparison of Lden in patients with MI ≤ 50 years with different 10-year LIFE-CVD risk categories (based on traditional risk factors)

Exploratory perceptions of successful ageing and preferences for information and support amongst sexually and gender diverse people living with HIV in Australia

The current exploratory study investigates self-reported perceptions of successful ageing, and preferences for information access and support, amongst sexually and gender diverse people living with HIV in Australia. Cross-sectional data, derived from a larger survey, were extracted for 12 participants who self-reported as living with HIV and completed questions pertaining to successful ageing and information/support preferences. Qualitative responses regarding successful ageing were explored through thematic analysis while descriptive statistics were used to analyse information/support preferences. Themes of (1) social factors, agency, and autonomy; (2) physical and mental wellbeing; and (3) considerations of care needs and information were generated from qualitative data about successful ageing. General practitioners (83.3%) and HIV support services (75.0%) were the most preferred sources of information about ageing and care supports. Findings from this exploratory study identify opportunities for policy improvements, provision of funding, and coordinated community support to enable sexually and gender diverse people living with HIV to experience successful ageing in Australia.

Traumatic brain injury rehabilitation for warfighters with post-traumatic stress.

While there is extensive empirical support and clinical guidance for the treatment of mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) individually, less is known about treating the comorbid presentation of both conditions. The purpose of this review article is to provide information on the mental health treatment needs of service members (SMs) engaged in traumatic brain injury (TBI) rehabilitation. It also aims to offer a framework for an integrated treatment approach to address the cognitive and psychological health needs of warfighters. We review the prevalence and outcomes associated with comorbid TBI and PTSD and present relevant access to care considerations. Additionally, we identify an integrated approach to TBI treatment which takes psychological trauma into consideration. We introduce a trauma-informed care (TIC) model with specified diagnostic and treatment considerations for the service member and veteran (SM/V) communities. TIC is a strengths-based framework that raises the system-wide awareness of treatment facilities to the impact of psychological trauma on behavioral health. A comprehensive diagnostic approach is recommended with considerations for symptom etiology. Clinical considerations derived from available guidelines are identified to meet critical treatment needs for SM/Vs presenting for TBI treatment with a remote history of mTBI and psychological trauma or known PTSD. Clinical practice guidelines are used to inform an integrated TBI treatment model and maximize rehabilitation efforts for warfighters. Given the prevalence of comorbid TBI and PTSD among SM/Vs and its impact on outcomes, this review presents the integration of appropriate diagnostics and treatment practices, including the incorporation of CPGs into TBI rehabilitation.

Dementia knowledge of family caregivers in Indonesia: A cross-sectional survey study.

As the population ages, the prevalence of dementia in Indonesia is rapidly increasing. In Indonesia, dementia care is primarily provided by informal or family caregivers. However, there is limited information about these caregivers' understanding of dementia and the factors that may influence their knowledge. Given that family members are the primary source of dementia care in Indonesia, it is essential to understand their knowledge and identify any gaps to inform future educational interventions. To explore the knowledge of dementia among Indonesian family caregivers and identify the sociodemographic factors associated with dementia knowledge. A cross-sectional survey was conducted in 2022 with 200 family caregivers who were members of Alzheimer's Indonesia (ALZI) support groups. These caregivers received invitations via ALZI to complete a translated version of the Dementia Knowledge Assessment Scale (DKAS-I). Independent t-tests and ANOVAs were used to examine differences in dementia knowledge across various subgroups, such as gender, education, and age. Seventy-six family caregivers completed the DKAS-I (38% response rate). Respondents had an average age of 49 years, were mostly female, and the majority were children of people with dementia. Over two-thirds of the DKAS-I items were answered correctly by family caregivers, with the 'care considerations' domain scoring the highest. Age, relationship to the person with dementia (being a child), and prior dementia education were significantly correlated with higher dementia knowledge in our sample. Family caregivers of people living with dementia across 10 Indonesian provinces who were members of dementia support groups demonstrated moderate dementia knowledge. Targeted education is needed to address gaps in knowledge about communication and behavioural changes in people with dementia and other areas related to quality of care. There is an opportunity for gerontological nurses with specialised dementia knowledge to lead educational initiatives for family caregivers to enhance their capacity. Future research should also investigate the dementia knowledge of caregivers in the general population, who may be older and less educated compared to the participants in this study.

Trends in Mental Health: A Review of the Most Influential Research on Depression in Children and Adolescents

BackgroundDepression is a common mental disorder in children and adolescents, with a global prevalence of approximately 33%, severely affecting their physical, mental health, and academic performance. This study aims to identify and assess the 100 most-cited articles (T100 articles) on depression in children and adolescents.MethodsThe T100 articles in the field of depression were retrieved from the SCI-E and SSCI databases. A comprehensive analysis of the T100 articles was conducted, including the number of citations, countries, journals, keywords, authors, and topics.ResultsBetween 1981 and 2021, T100 articles in child and adolescent depression received 423 to 3949 citations. Most articles originated from the USA, with Kovacs M as the top-ranked author. The University of Pittsburgh and Columbia University published the top two T100 articles. The T100 articles were published in 36 journals, led by AMA Psychiatry. Co-occurrence keywords analyses reveal six key foci: Pathogenesis of Depression, Treatment of MDD in Children, Early Childhood Treatment, Adolescent Depression Manifestations, Gender and Depression, and Primary Care Considerations, with pathogenesis as a future trend.ConclusionsOur research presents an exhaustive list of the most highly cited articles on depression in children and adolescents. Our findings not only underscore the significance of international cooperation but also reveal a pressing need to prioritize and bolster preventive research, particularly the development and refinement of early screening and intervention programs.

Pediatric Obesity Pharmacotherapy: State of the Science, Research Gaps, and Opportunities.

Pediatric obesity is a major public health problem, affecting nearly 20% of children and adolescents living in the United States. In 2023, the American Academy of Pediatrics released its first clinical practice guideline for the evaluation and management of child and adolescent obesity and recommended integrating health behavior and lifestyle interventions with pharmacological treatment when medically indicated. However, there is a limited evidence base to guide antiobesity medication treatment decisions in clinical practice and limited data on long-term safety during this critical period of growth and development in youth. Thus, in November of 2023, the National Institute of Diabetes and Digestive and Kidney Diseases sponsored a workshop to identify knowledge gaps and opportunities for research on the use of pharmacotherapy for obesity in children and adolescents. Leading scientific and clinical experts in obesity pathophysiology and treatment, pharmacotherapy, clinical trial design, and health equity and disparities, among others, identified gaps in clinical trial design, guidance for clinical use of medications in children and adolescents, additional treatment outcomes beyond body fat or weight, and improvement in care delivery. Adolescent patients and caregivers with lived experience of obesity and weight management were also invited to participate in a panel discussion, providing personal perspectives on living with obesity, clinical care considerations, and research needs. This article summarizes the workshop proceedings on the state of the science and identifies gaps and opportunities for future research to inform optimal and equitable medical management of children and adolescents with obesity.

The impact of femoral/internal jugular vein selection on postoperative infection in central vein cannulation of newborns undergoing cardiac surgery.

In the low-weight newborn patient group, the development of catheter related bloodstream infections after cardiac surgery significantly impacts morbidity and mortality. In our study, the effects of choosing femoral or internal jugular vein localization in newborns on postoperative infection will be examined. Our hypothesis is that there may be a higher risk of catheter related bloodstream infections in the femoral region. This study was conducted retrospectively on newborn cases who underwent congenital heart surgery between September 1, 2020, and March 1, 2022. The cases were divided into 2 groups: those with central catheters inserted in the femoral and in internal jugular veins. Postoperative infection parameters were examined and the results were statistically evaluated. The study was conducted with a total of 201 newborn cases, of which 61.2% (n = 123) were male and 38.8% (n = 78) were female. The age of the cases ranged from 0 to 1 month, with a mean of 12 ± 9 days. Weight measurements ranged from 1.8 to 5.5 kg, with a mean of 3.20 ± 0.66 kg. Central catheters were placed in the femoral vein (FV) region in 71.6% of the babies (n = 144) and in the internal jugular vein region in 28.4% (n = 57). When culture results were examined between postoperative days 3 to 14, blood culture tests were positive in 12.4% (n = 25). The most common bacteria in positive cases were Klebsiella spp. (n = 13) and methicillin-resistant Staphylococcus aureus (n = 5). There was no statistically significant difference in blood culture results between the groups (P > .05). Changes in white blood cells, C-reactive protein, and procalcitonin measurements between preoperative and postoperative day 3 did not show statistically significant difference between the groups (P > .05). According to the results of our study, the placement of FV and internal jugular vein in neonates undergoing cardiac surgery did not differ in terms of postoperative infection risk. With appropriate sterilization, preventive measures and care considerations, FV or internal jugular vein region may be preferred based on the practitioner's expertise and choice in this patient group.

Chiropractor Perceptions of Non-registered Practitioners Utilizing Spinal Manipulative Therapy in Hong Kong: A Cross-Sectional Survey.

Objective This study aimed to explore registered chiropractors' perceptions of the use of spinal manipulative therapy (SMT) by non-registered practitioners in Hong Kong, assessing the associated risks, adverse events, and patient management approaches. Method A cross-sectional survey was conducted among registered chiropractors in Hong Kong using an online questionnaire. The survey, distributed via chiropractic associations from January 26to March 20, 2024, gathered data on the practitioners' experiences with patients previously treated by non-registered practitioners, including the types of adverse events observed and subsequent interventions required. Descriptive statistics were used to analyze the data. A total of 134 valid responses were received. Results Among respondents, a significant proportion (91%) of chiropractors reported observing adverse effects in patients treated by non-registered practitioners, with the most common issues being the aggravation of existing symptoms (95.5%) and new or unexpected complaints (82.8%). The most frequently required interventions included imaging (97%), medication (58.2%), and specialist referrals (59%). Respondents indicated that these adverse events could often have been prevented if proper training and certification were in place. Common reasons cited by patients for seeking care from non-registered practitioners included a lack of awareness about licensed care (90.3%) and cost considerations (80.6%). Conclusion The study highlights concerns reported by registered chiropractors regarding the safety of SMT performed by non-registered practitioners in Hong Kong. These concerns emphasize the need for enhanced public education on potential risks and stricter regulatory oversight. Although direct data on the occurrence of adverse events was not collected, the findings suggest that many risks could potentially be mitigated with proper training, underscoring the importance of credentialed care in ensuring patient safety.

Acute Lymphoblastic Leukemia, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology.

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for acute lymphoblastic leukemia (ALL) provide recommendations for management of ALL, with a focus on the classification of ALL subtypes based on immunophenotype and cytogenetic/molecular markers; risk assessment and stratification for risk-adapted therapy; treatment strategies for Philadelphia chromosome (Ph)-positive and Ph-negative ALL for both adolescent and young adult and adult patients; and supportive care considerations. This selection from the NCCN Guidelines for ALL focuses on treatment recommendations for adults with newly diagnosed Ph-negative ALL based on current evidence.

Flexibly Incorporating the Dyad into Psychosocial Intervention: Considerations for Neuropalliative Care.

This paper reviews dyadic psychosocial intervention approaches that flexibly incorporate both dyad members despite challenges to equitable involvement due to cognitive limitations or limited availability. We provide an overview, analysis, and examples for the following dyadic intervention approaches: (1) shared interventions that involve each dyad member equitably (i.e., higher care recipient cognition, higher care-partner availability); (2) patient-focused interventions that primarily engage care recipients with early stages of neurocognitive disorders, yet include care-partners in select sessions and target dyadic and relationship needs (i.e., higher care recipient cognition, lower care-partner availability); and (3) care-partner focused interventions that primarily engage care-partners, yet still address care recipient and relationship needs (i.e., lower care recipient cognition, higher care-partner availability). In our review, we propose a flexible definition of dyadic psychosocial intervention that considers the continuum of individuals' involvement, measurement, content, and conceptual background. We conclude with a discussion of implications for neuropalliative care.

Safe and supportive prescribing in transgender and non-binary patients with cancer.

Global prevalence rates for transgender individuals vary with estimates ranging from 0.3% to 1%, translating to a potential global population of 24.3 million to 81 million. It is estimated that one in two people will develop cancer in their lifetime. Gender-affirming hormone therapy (GAHT) is a common medical intervention for transgender and non-binary individuals. GAHT requires careful consideration for concurrent medical care due to potential drug interactions and physiological changes. A multi-disciplinary team with expertise in transgender health, oncology and pharmacy met to develop a document summarizing current knowledge on the topic for practical use. The team included trans and non-binary authors who shaped the document's language and focus. The document gives a status update on the current understanding of GAHT and how this may intersect with the safe prescribing of systemic anti-cancer therapies (SACT). The document underwent multiple review stages including internal review, review by the British Oncology Pharmacy Association (BOPA) EDI Subcommittee and, finally, BOPA Executive Committee review and final approval. Key recommendations of this document include the use of inclusive and effective communication, vigilant monitoring of kidney function and cardiovascular health, and considerations for hormone receptor-positive cancers. The document also recognizes the multidisciplinary nature of transgender healthcare and where this relates to social prescribing.

Gastroenteropancreatic neuroendocrine neoplasms: epidemiology, genetics, and treatment.

The incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP NEN) is increasing at a rapid pace and is becoming an increasingly important consideration in clinical care. Epidemiological data from multiple countries indicate that the incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP NEN) exhibits regional, site-specific, and gender-based variations. While the genetics and pathogenesis of some GEP NEN, particularly pancreatic NENs, have been investigated, there are still many mechanisms that require further investigation. The management of GEP NEN is diverse, but surgery remains the primary option for most cases. Peptide receptor radionuclide therapy (PRRT) is an effective treatment, and several clinical trials are exploring the potential of immunotherapy and targeted therapy, as well as combination therapy.

“Somebody has to be crazy about that kid”: Speculating on the transformative recordkeeping potential of the caring corporate parent

Just as archival scholarship has increasingly engaged in conversations around care and holistic considerations of the agency of records subjects, the child welfare systems of the modern Western world have been moving towards conversations that aim to centre and celebrate the voice of the child in new and important ways. However, too often are these conversations held back by the enormity of the issue and the overhaul that would have to take place for philosophy to match with practice. In this paper, I suggest that part of the problem is that we have been trying to make these changes philosophy first, placing a new way of thinking on top of an old way of doing—an approach that will never generate change. Leaning in to using speculation to imagine what the new recordkeeping of a caring system might look like, I propose that the act of recordkeeping is the fulcrum that could make caring child welfare a reality and illustrate some of the avenues through which we might pursue instigating the systemic changes needed if we are to see the agency and perspectives of children prioritised in child welfare and protection practices.

Exploring the User Acceptability and Feasibility of a Clinical Decision Support Tool Designed to Facilitate Timely Diagnosis of New-Onset Type 1 Diabetes in Children: Qualitative Interview Study Among General Practitioners.

Up to half of the children with new-onset type 1 diabetes present to the hospital with diabetic ketoacidosis, a life-threatening condition that can develop because of diagnostic delay. Three-quarters of Australian children visit their general practitioner (GP) the week before presenting to the hospital with diabetic ketoacidosis. Our prototype, DIRECT-T1DM (Decision-Support for Integrated, Real-Time Evaluation and Clinical Treatment of Type 1 Diabetes Mellitus), is an electronic clinical decision support tool that promotes immediate point-of-care testing in general practice to confirm the suspicion of diabetes. This avoids laboratory testing, which has been documented internationally as a cause of diagnostic delay. In this investigation, we aimed to pilot and assess the feasibility and acceptability of our prototype to GP end users. We also explored the challenges of diagnosing type 1 diabetes in the Australian general practice context. In total, 4 GPs, a pediatric endocrinologist, and a PhD candidate were involved in conceptualizing the DIRECT-T1DM prototype, which was developed at the Department of General Practice and Primary Care at the University of Melbourne. Furthermore, 6 GPs were recruited via convenience sampling to evaluate the tool. The study involved 3 phases: a presimulation interview, simulated clinical scenarios, and a postsimulation interview. The interview guide was developed using the Consolidated Framework for Implementation Research (CFIR) as a guide. All phases of the study were video, audio, and screen recorded. Audio recordings were transcribed by the investigating team. Analysis was carried out using CFIR as the underlying framework. Major themes were identified among three domains and 7 constructs of the CFIR: (1) outer setting-time pressure, difficulty in diagnosing pediatric type 1 diabetes, and secondary care considerations influenced GPs' needs regarding DIRECT-T1DM; (2) inner setting-DIRECT-T1DM fits within existing workflows, it has a high relative priority due to its importance in patient safety, and GPs exhibited high tension for change; and (3) innovation-design recommendations included altering coloring to reflect urgency, font style and bolding, specific language, information and guidelines, and inclusion of patient information sheets. End-user acceptability of DIRECT-T1DM was high. This was largely due to its implications for patient safety and its "real-time" nature. DIRECT-T1DM may assist in appropriate management of children with new-onset diabetes, which is an uncommon event in general practice, through safety netting.