Key result
Clinical decision support implementation is linked to an ~88% increase in recognizing pediatric elevated BP.
Why the study?
Under-diagnosis of pediatric hypertension remains pervasive due to difficulty recognizing elevated systolic blood pressures.
Does a clinical decision support tool improve the recognition of elevated systolic blood pressures in pediatric patients?
Observational (n=44,351)
Does a clinical decision support tool improve the recognition of elevated systolic blood pressures in pediatric patients?
Absolute Event Rate: 33.7% vs 17.9%
p-value: p=0.001
Implementation of a clinical decision support tool significantly improves the recognition of elevated systolic blood pressures in pediatric patients, particularly when combined with repeat measurements.
Under-diagnosis of pediatric hypertension remains pervasive due to difficulty recognizing elevated systolic blood pressures (SBPs). We performed a retrospective review comparing recognition of and response to elevated SBPs ≥95th percentile before and after development of a clinical decision support tool (CDST) in an academic pediatric system. Of 44,351 encounters, 477 had elevated SBPs with documented recognition of an elevated SBP in 17.9% of encounters pre-CDST that increased to 33.7% post-CDST ( P = .001). Post-CDST, 75.5% of elevated SBPs had repeat measurement, with 90.8% of initially elevated SBPs normalizing to <95th percentile. If repeat measurement was obtained and SBP remained elevated, documented recognition increased from 14.0 to 83.3% ( P < .0001). These data support using the CDST is associated with increased identification of elevated SBPs in children with greatest improvements associated with repeat SBP measurement. This suggests targeted training and support systems at medical intake would be high yield for increasing recognition of elevated SBP.
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Meisner et al. (2022) conducted an observational in Pediatric hypertension (n=44,351). Clinical decision support tool (CDST) vs. Pre-CDST (before implementation of the tool) was evaluated on Documented recognition of an elevated systolic blood pressure (p=0.001). Implementation of a clinical decision support tool increased documented recognition of elevated systolic blood pressures in pediatric encounters from 17.9% to 33.7% (P=0.001).
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