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Leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge

BACKGROUND: Guidelines recommend moderate to high-intensity statins and antithrombotic agents in patients with atherosclerotic cardiovascular disease (ASCVD). However, guideline-directed medical therapy (GDMT) remains suboptimal. METHODS: In this quality initiative, best practice alerts (BPA) in the...

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Autores principales: Vani, Anish, Kan, Karen, Iturrate, Eduardo, Levy-Lambert, Dina, Smilowitz, Nathaniel R., Saxena, Archana, Radford, Martha J., Gianos, Eugenia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550339/
https://www.ncbi.nlm.nih.gov/pubmed/32986236
http://dx.doi.org/10.5603/CJ.a2020.0126
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author Vani, Anish
Kan, Karen
Iturrate, Eduardo
Levy-Lambert, Dina
Smilowitz, Nathaniel R.
Saxena, Archana
Radford, Martha J.
Gianos, Eugenia
author_facet Vani, Anish
Kan, Karen
Iturrate, Eduardo
Levy-Lambert, Dina
Smilowitz, Nathaniel R.
Saxena, Archana
Radford, Martha J.
Gianos, Eugenia
author_sort Vani, Anish
collection PubMed
description BACKGROUND: Guidelines recommend moderate to high-intensity statins and antithrombotic agents in patients with atherosclerotic cardiovascular disease (ASCVD). However, guideline-directed medical therapy (GDMT) remains suboptimal. METHODS: In this quality initiative, best practice alerts (BPA) in the electronic health record (EHR) were utilized to alert providers to prescribe to GDMT upon hospital discharge in ASCVD patients. Rates of GDMT were compared for 5 months pre- and post-BPA implementation. Multivariable regression was used to identify predictors of GDMT. RESULTS: In 5985 pre- and 5568 post-BPA patients, the average age was 69.1 ± 12.8 years and 58.5% were male. There was a 4.0% increase in statin use from 67.3% to 71.3% and a 3.1% increase in antithrombotic use from 75.3% to 78.4% in the post-BPA cohort. CONCLUSIONS: This simple EHR-based initiative was associated with a modest increase in ASCVD patients being discharged on GDMT. Leveraging clinical decision support tools provides an opportunity to influence provider behavior and improve care for ASCVD patients, and warrants further investigation.
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spelling pubmed-95503392022-10-11 Leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge Vani, Anish Kan, Karen Iturrate, Eduardo Levy-Lambert, Dina Smilowitz, Nathaniel R. Saxena, Archana Radford, Martha J. Gianos, Eugenia Cardiol J Clinical Cardiology BACKGROUND: Guidelines recommend moderate to high-intensity statins and antithrombotic agents in patients with atherosclerotic cardiovascular disease (ASCVD). However, guideline-directed medical therapy (GDMT) remains suboptimal. METHODS: In this quality initiative, best practice alerts (BPA) in the electronic health record (EHR) were utilized to alert providers to prescribe to GDMT upon hospital discharge in ASCVD patients. Rates of GDMT were compared for 5 months pre- and post-BPA implementation. Multivariable regression was used to identify predictors of GDMT. RESULTS: In 5985 pre- and 5568 post-BPA patients, the average age was 69.1 ± 12.8 years and 58.5% were male. There was a 4.0% increase in statin use from 67.3% to 71.3% and a 3.1% increase in antithrombotic use from 75.3% to 78.4% in the post-BPA cohort. CONCLUSIONS: This simple EHR-based initiative was associated with a modest increase in ASCVD patients being discharged on GDMT. Leveraging clinical decision support tools provides an opportunity to influence provider behavior and improve care for ASCVD patients, and warrants further investigation. Via Medica 2022-09-30 /pmc/articles/PMC9550339/ /pubmed/32986236 http://dx.doi.org/10.5603/CJ.a2020.0126 Text en Copyright © 2022 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
spellingShingle Clinical Cardiology
Vani, Anish
Kan, Karen
Iturrate, Eduardo
Levy-Lambert, Dina
Smilowitz, Nathaniel R.
Saxena, Archana
Radford, Martha J.
Gianos, Eugenia
Leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge
title Leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge
title_full Leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge
title_fullStr Leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge
title_full_unstemmed Leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge
title_short Leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge
title_sort leveraging clinical decision support tools to improve guideline-directed medical therapy in patients with atherosclerotic cardiovascular disease at hospital discharge
topic Clinical Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550339/
https://www.ncbi.nlm.nih.gov/pubmed/32986236
http://dx.doi.org/10.5603/CJ.a2020.0126
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