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Clinical decision support for stroke prevention in atrial fibrillation (CDS-AF): Rationale and design of a cluster randomized trial in the primary care setting
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Primary Health Care in Norrköping.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
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2017 (English)In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 187, 45-52 p.Article in journal (Refereed) Published
Abstract [en]

Background Atrial fibrillation (AF) is associated with substantial morbidity, in particular stroke. Despite good evidence for the reduction of stroke risk with anticoagulant therapy, there remains a significant undertreatment. The main aim of the current study is to investigate whethera clinical decision support tool for stroke prevention (CDS) integrated in the electronic health record can improve adherence to guidelines for stroke prevention in patients with AF. Methods We will conduct a cluster randomized trial where 43 primary care clinics in the county of Ostergotland, Sweden (population 444,347), will be randomized to be part of the CDS intervention or serve as controls. The CDS will alert responsible physicians of patients with AF and increased risk for thromboembolism according to the CHA(2)DS(2)VASc (Congestive heart failure, Hypertension, Age 74 years, Diabetes mellitus, previous Stroke/TIA/thromboembolism, Vascular disease, Age 65-74 years, Sex category (i.e. female sex)) algorithm without anticoagulant therapy. The primary end point will be adherence to guidelines after 1 year. Conclusion The present study will investigate whether a clinical decision support system integrated in an electronic health record can increase adherence to guidelines regarding anticoagulant therapy in patients with AF.

Place, publisher, year, edition, pages
MOSBY-ELSEVIER , 2017. Vol. 187, 45-52 p.
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Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-138481DOI: 10.1016/j.ahj.2017.02.009ISI: 000401053600006PubMedID: 28454807OAI: oai:DiVA.org:liu-138481DiVA: diva2:1111674
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2017-06-19

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Karlsson, LarsNilsson, StaffanCharitakis, EmmanouilBång, MagnusJohansson, GustavNilsson, LennartJanzon, Magnus
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Department of Medical and Health SciencesFaculty of Medicine and Health SciencesDivision of Community MedicinePrimary Health Care in NorrköpingHuman-Centered systemsFaculty of Science & EngineeringDepartment of Computer and Information ScienceDivision of Cardiovascular MedicineDepartment of Cardiology in Linköping
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