Computerized clinical decision support to improve stroke prevention therapy in primary care management of atrial fibrillation: a cluster randomized trial.

Jafna Cox¹, Laura Hamilton², Lehana Thabane³, Gary Foster⁴, James MacKillop⁵, Feng Xie⁶, Antonio Ciaccia⁷, Shurjeel Choudhri⁸, Joanna Nemis-White⁹, Ratika Parkash¹⁰,

¹Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: jafna.cox@dal.ca.

²QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia.

³Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario Canada; Departments of Anesthesia/Pediatrics, McMaster University, Hamilton, Ontario Canada; Biostatistics Unit, Centre for Evaluation of Medicine, McMaster University, Hamilton, Ontario Canada; Population Health Research Institute (PHRI), Hamilton Health Sciences, McMaster University, Hamilton, Ontario Canada; Department of Health Research Methods, Evidence, and Impact; McMaster University, Hamilton, Ontario Canada.

⁴Department of Health Research Methods, Evidence, and Impact; McMaster University, Hamilton, Ontario Canada; Biostatistics Unit, St. Joseph's Healthcare, Hamilton, Ontario, Canada.

⁵Sydney Primary Care Medical Clinic, Sydney, Nova Scotia.

⁶Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario Canada; Centre for Health Economics and Policy Analysis, McMaster University.

⁷Medical Affairs - Cardiovascular Medicine, Bayer Inc, Mississauga, Ontario, Canada.

⁸Medical and Scientific Affairs, Bayer Inc, Mississauga, Ontario, Canada.

⁹Strive Health Management Consulting Ltd., Halifax, Nova Scotia, Canada.

¹⁰Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

PubMed DOI

Abstract

BACKGROUND: Despite guidelines supporting antithrombotic therapy use in atrial fibrillation (AF), under-prescribing persists. We assessed whether computerized clinical decision support (CDS) would enable guideline-based antithrombotic therapy for AF patients in primary care. METHODS: This cluster randomized trial of CDS versus usual care (UC) recruited participants from primary care practices acr…

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