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临床决策支持是否增加了适当的药物处方,以减少心血管风险?

David Boston¹, Annie E Larson², Christina R Sheppler²

¹From the OCHIN Inc., PO Box 5426, Portland, OR (DB, AEL, JH, RG); Kaiser Permanente Northwest, Center for Health Research, 3800 N Interstate Ave, Portland, OR (CRS); HealthPartners Institute, 8170 33rd Ave So 23301a, Minneapolis, MN (PJOC, JMSH). bostond@ochin.org.

Journal of the American Board of Family Medicine : JABFM

|September 13, 2023

概括

一个临床决策支持 (CDS) 系统通过增加对高血压和脂质失调的药物处方来改善心血管疾病 (CVD) 风险管理. 来自CDS系统的优先推增强了降低心血管疾病风险的处方模式.

科学领域:

医疗信息学医疗信息学
心血管医学心血管医学
临床决策支持系统临床决策支持系统

背景情况:

心血管疾病 (CVD) 仍然是导致死亡的主要原因,需要有效的风险管理策略.
临床决策支持 (CDS) 系统有可能优化对心血管疾病风险因素的处方模式.
基于临床益处的CDS建议的优先考虑可能会增强它们对患者护理的影响.

研究的目的:

评估优先临床决策支持 (CDS) 系统对心血管疾病 (CVD) 风险因素的处方的影响.
为了确定CDS建议,按最大到最小的CVD风险降低效益排序,是否影响处方模式.

主要方法:

2018年9月至2020年3月期间,来自70个社区卫生中心的集群随机试验数据的二次分析.
纳入标准:从未服用过药物的40至75岁的患者,患有无法控制的心血管疾病风险因素,已知的糖尿病或心血管疾病.
在CDS干预诊所和对照诊所之间对高血压,脂质失调和戒烟的处方率的比较.

主要成果:

使用CDS的干预诊所对高血压的处方比使用CDS的干预诊所高,但与对照诊所没有显著差异.
在使用CDS的干预诊所中,处方失脂症和戒烟药物的处方明显高于被解雇和对照接触者.
处方率通常根据CDS建议的优先级水平增加,除了失脂症.

结论:

使用具有优先级建议的CDS系统显著增加了大多数心血管风险因素的处方.
在CDS系统中显示优先行动可以是改善心血管风险管理的有效策略.
这种方法突显了CDS在临床实践中增强可修改心血管疾病风险因素的管理方面的潜力.

关键词:

心脏病学心脏病学心血管疾病心血管疾病临床决策支持系统临床决策支持系统临床试验临床试验社区卫生中心社区卫生中心决策方式决策方式健康公平卫生公平医疗信息学医疗信息学实践指南实践指南主要医疗保健是主要的医疗保健.提高质量提高质量

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