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March 11, 2000BMJOpen Access

Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial

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Why the study?

Does a computer based clinical decision support system and risk chart reduce cardiovascular risk and blood pressure in hypertensive patients aged 60-79?

Population

614 patients aged between 60 and 79 years with high blood pressure

Comparison

Computer based clinical decision support system… vs Usual care

Design

RCT, Cluster randomised

Key result

A computer-based clinical decision support system did not reduce absolute cardiovascular risk, with patients more likely to have a 5-year risk ≥10% compared to a chart alone (OR 2.3; 95% CI 1.1-4.8).

Authors

AMAlan Montgomery

Discussion

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Overview

Computer-based decision support should not supplant risk charts in hypertension; challenges presumed benefits of digital tools for risk reduction.

Study Design

Type

RCT (n=614)

Randomization

Cluster

Multicenter

Yes

Structured PICO

Does a computer based clinical decision support system and risk chart reduce cardiovascular risk and blood pressure in hypertensive patients aged 60-79?

P
Population
614 patients aged between 60 and 79 years with high blood pressure
I
Intervention
Computer based clinical decision support system plus cardiovascular risk chart, or cardiovascular risk chart alone
C
Comparator
Usual care
O
Outcome
Percentage of patients in each group with a five year cardiovascular risk >/=10%, systolic blood pressure, diastolic blood pressure, prescribing of cardiovascular drugssurrogate

Main Result

Effect estimate: OR 2.3 (95% CI 1.1 to 4.8)

A computer-based clinical decision support system did not improve cardiovascular risk or blood pressure control in hypertensive patients, though risk charts alone reduced systolic blood pressure.

Cite This Study

Alan Montgomery (2000) conducted an RCT in Hypertension (n=614). Computer based clinical decision support system plus cardiovascular risk chart vs. Cardiovascular risk chart alone or usual care was evaluated on Percentage of patients with a five year cardiovascular risk >=10% (OR 2.3, 95% CI 1.1 to 4.8). A computer-based clinical decision support system did not reduce absolute cardiovascular risk, with patients more likely to have a 5-year risk ≥10% compared to a chart alone (OR 2.3; 95% CI 1.1-4.8).

synapsesocial.com/papers/6a0b8ca5815f2698a1d099c3https://doi.org/10.1136/bmj.320.7236.686
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