Key result
Computerized decision support for AF fails to improve patient utility scores or satisfaction versus usual care.
Why the study?
To assess and compare patient-reported health-related quality of life and patient-reported experience with AF care between computerized clinical decision support and usual care.
Does a computerized clinical decision support system improve patient-reported health-related quality of life and patient experience in patients with atrial fibrillation compared to usual care?
RCT (n=1,145)
Cluster
Yes
Does a computerized clinical decision support system improve patient-reported health-related quality of life and patient experience in patients with atrial fibrillation compared to usual care?
Implementation of a computerized clinical decision support system for atrial fibrillation in primary care did not significantly improve patient-reported quality of life or satisfaction compared to usual care at 12 months.
Computerized decision support does not improve AF patient-reported outcomes; challenges assumptions of benefit and does not support routine implementation.
Background The IMPACT-AF (Integrated Management Program Advancing Community Treatment of Atrial Fibrillation) trial is a prospective, randomized, cluster design trial comparing atrial fibrillation management with a computerized clinical decision support system with usual care (control) in the primary care setting of Nova Scotia, Canada. The objective of this analysis was to assess and compare patient-reported health-related quality of life and patient-reported experience with atrial fibrillation care between clinical decision support and control groups. Methods and Results Health-related quality of life was measured using the EuroQol 5-dimensional 5-level scale, whereas patient-reported experience was assessed using a self-administered satisfaction questionnaire, both assessed at baseline and 12 months. Health utilities were calculated using the Canadian EuroQol 5-dimensional 5-level value set. Descriptive statistics and generalized estimating equations were used to compare between groups. Among 1145 patients enrolled in the trial, 717 had complete EuroQol 5-dimensional 5-level data at baseline. The mean age of patients was 73.53 years, and 61.87% were men. Mean utilities at baseline were 0.809 (SD, 0.157) and 0.814 (SD, 0.157) for clinical decision support and control groups, respectively. At baseline, most patients in both groups reported being "very satisfied" with the care received for their atrial fibrillation. There were no statistically significant differences in utility scores or patient satisfaction between groups at 12 months. Conclusions Health-related quality of life of patients remained stable over 12 months, and there was no significant difference in patient satisfaction or utility scores between clinical decision support and control groups. Registration information clinicaltrials.gov. Identifier: NCT01927367.
No takes yet. Share an insight, caveat, or question.
Humphries et al. (2021) conducted an RCT in Atrial Fibrillation (n=1,145). Computerized clinical decision support system vs. Usual care was evaluated on Patient-reported health-related quality of life (utility scores) and patient satisfaction at 12 months. A computerized clinical decision support system for atrial fibrillation management did not significantly improve patient-reported utility scores or satisfaction compared with usual care at 12 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: