学习实施基于指导方针的决策支持系统,以改善中国初级保健中的高血压治疗:实用集群随机对照试验
Jiali Song1, Xiuling Wang1, Bin Wang1
1National Clinical Research Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, National Centre for Cardiovascular Diseases, Beijing, China.
概括
临床决策支持系统 (CDSS) 在中国改善了基于指南的高血压治疗. 这项技术提高了患者的护理,导致更好的血压控制和更安全,更有效的高血压管理.
科学领域:
- 心血管医学 心血管医学
- 医疗信息学 医疗信息学
- 初级保健研究研究初级保健研究
背景情况:
- 在初级保健中,高血压的管理需要遵守临床指南.
- 临床决策支持系统 (CDSS) 有潜力提高治疗质量.
- 在各种初级保健机构中评估CDSS的有效性至关重要.
研究的目的:
- 评估基于电子健康记录的CDSS对符合指南的抗高血压治疗的影响.
- 为了确定CDSS是否能改善血压控制和减少中国初级保健中的不良事件.
主要方法:
- 一个务实的,开放的,集群随机试验,涉及中国94个初级保健机构.
- 干预组使用了基于EHR的CDSS推抗高血压疗法.
- 对照组接受了没有CDSS的常规护理.
主要成果:
- 而CDSS组的治疗访问比例明显高于指导方针 (77.8%与62.2%相比).
- 在CDSS组中观察到静脉压的较大降低 (-1.5 mm Hg vs 0.3 mm Hg).
- 血压控制率显示CDSS的改善趋势不显著 (69.0%对64.6%).
结论:
- 在中国的初级保健中实施CDSS显著改善了指导方针推的抗高血压治疗.
- 该系统在降低血压方面表现出适度但显著的影响.
- CDSS提出了一种安全有效的策略,以提高高血压护理的提供.
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