Impact of electronic clinical decision support on adherence to guideline-recommended treatment for hyperlipidaemia, atrial fibrillation and heart failure: protocol for a cluster randomised trial

Maya Elizabeth Kessler, Rickey E. Carter, David Allan Cook, Daryl J Kor, Paul McKie, Laurie J. Pencille, Marianne R. Scheitel, Rajeev Chaudhry

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

INTRODUCTION: Clinical practice guidelines facilitate optimal clinical practice. Point of care access, interpretation and application of such guidelines, however, is inconsistent. Informatics-based tools may help clinicians apply guidelines more consistently. We have developed a novel clinical decision support tool that presents guideline-relevant information and actionable items to clinicians at the point of care. We aim to test whether this tool improves the management of hyperlipidaemia, atrial fibrillation and heart failure by primary care clinicians.

METHODS/ANALYSIS: Clinician care teams were cluster randomised to receive access to the clinical decision support tool or passive access to institutional guidelines on 16 May 2016. The trial began on 1 June 2016 when access to the tool was granted to the intervention clinicians. The trial will be run for 6 months to ensure a sufficient number of patient encounters to achieve 80% power to detect a twofold increase in the primary outcome at the 0.05 level of significance. The primary outcome measure will be the percentage of guideline-based recommendations acted on by clinicians for hyperlipidaemia, atrial fibrillation and heart failure. We hypothesise care teams with access to the clinical decision support tool will act on recommendations at a higher rate than care teams in the standard of care arm.

ETHICS AND DISSEMINATION: The Mayo Clinic Institutional Review Board approved all study procedures. Informed consent was obtained from clinicians. A waiver of informed consent and of Health Insurance Portability and Accountability Act (HIPAA) authorisation for patients managed by clinicians in the study was granted. In addition to publication, results will be disseminated via meetings and newsletters.

TRIAL REGISTRATION NUMBER: NCT02742545.

Original languageEnglish (US)
Pages (from-to)e019087
JournalBMJ Open
Volume7
Issue number12
DOIs
StatePublished - Dec 4 2017

Fingerprint

Clinical Decision Support Systems
Guideline Adherence
Hyperlipidemias
Atrial Fibrillation
Heart Failure
Guidelines
Point-of-Care Systems
Informed Consent
Health Insurance Portability and Accountability Act
Therapeutics
Informatics
Research Ethics Committees
Standard of Care
Practice Guidelines
Publications
Primary Health Care
Outcome Assessment (Health Care)

Keywords

  • adult cardiology
  • health informatics
  • internal medicine

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Impact of electronic clinical decision support on adherence to guideline-recommended treatment for hyperlipidaemia, atrial fibrillation and heart failure : protocol for a cluster randomised trial. / Kessler, Maya Elizabeth; Carter, Rickey E.; Cook, David Allan; Kor, Daryl J; McKie, Paul; Pencille, Laurie J.; Scheitel, Marianne R.; Chaudhry, Rajeev.

In: BMJ Open, Vol. 7, No. 12, 04.12.2017, p. e019087.

Research output: Contribution to journalArticle

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