在初级保健 (INIRSHA-PC) 中断式与非中断式提醒:随机临床试验的协议和统计分析计划
Aileen P Wright1,2, Leena Choi3,4, Kylie G Nairon5
1Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA aileen.p.wright.1@vumc.org.
BMJ open
|January 28, 2026
概括
这项研究比较了中断和非中断的电子健康记录提醒,以增加心血管疾病预防的他类药物处方. 结果将澄清哪种提醒类型最能支持遵循指南的他类药物治疗.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 临床试验方法论 临床试验方法论
背景情况:
- 类药物对于预防心血管疾病至关重要,但处方不足.
- 电子健康记录 (EHR) 临床决策支持系统旨在改善符合指南的处方.
- 电子健康记录中的中断提醒可能会导致警报疲劳,而非中断警报的有效性尚不清楚.
研究的目的:
- 评估关于他类药物处方率的中断式和非中断式电子病历提醒的比较有效性.
- 为了评估不同类型的提醒对初级保健患者的治疗对他类药物的启动的影响.
- 通过EHR干预,为优化他类药物处方的策略提供信息.
主要方法:
- 范德比尔特大学医学中心的一项务实,三臂,并行组随机对照试验 (INIRSHA-PC).
- 招募3000名符合条件但未接受他类药物治疗的初级保健患者 (年龄在18-74岁之间),按1:1:1随机分配到间歇性提醒,非间歇性提醒或常规护理.
- 主要结局:注册后24小时内处方他类药物;次要结局包括12个月处方和LDL胆固醇水平.
主要成果:
- 数据收集正在进行中;结果正在等待.
- 该研究旨在提供关于不同EHR提醒策略的比较有效性的最终证据.
- 数据收集计划完成日期为2025年11月19日.
结论:
- 这些发现将指导实施有效的基于EHR的干预措施,以改善他类药物处方.
- 了解中断与非中断警报的影响是减少警报疲劳和增强临床工作流程的关键.
- 本试验解决了关于通过有针对性的EHR决策支持优化心血管疾病预防的关键知识差距.
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