Clinical Decision Support May Cut Cardiovascular Disease Risk

Use of clinical decision support systems (CDSSs) is associated with improvements in reversible risk for cardiovascular disease (CVD) among patients with the highest levels of baseline risk, according to a study published online Feb. 4 in JAMA Network Open.

Rachel Gold, Ph.D., from Kaiser Permanente Northwest in Portland, Oregon, and colleagues evaluated the impact of a CDSS targeting CVD risk in 70 community health centers (CHCs; 42 randomly assigned to CDSS). The target population included patients (aged 40 to 75 years) with (1) diabetes or atherosclerotic CVD and at least one uncontrolled major risk factor for CVD or (2) a total reversible CVD risk of ≥10 percent.

The researchers found that the CDSS was used at 19.8 percent of 91,988 eligible intervention clinic encounters. There was no population-level reduction observed in CVD risk among patients in control or intervention clinics, but mean reversible risk significantly improved more among patients in control versus intervention clinics. When CDSS was used, there were greater decreases in both risk measures among patients with high baseline risk in intervention versus control clinics: mean reversible risk of −4.4 versus 2.7 percent.

"The use of a CDSS in CHCs has the potential to improve reversible risk of cardiovascular disease among socioeconomically vulnerable high-risk patients; strategies to increase CDSS adoption in this setting are needed," the authors write.