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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
Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. 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, Primary Care Center, Primary Health Care Center Vikbolandet.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
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, p. 45-52Article 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, p. 45-52
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Cardiac and Cardiovascular Systems
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URN: urn:nbn:se:liu:diva-138481DOI: 10.1016/j.ahj.2017.02.009ISI: 000401053600006PubMedID: 28454807OAI: oai:DiVA.org:liu-138481DiVA, id: diva2:1111674
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2018-05-14

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Karlsson, Lars O.Charitakis, Emmanouil

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Karlsson, Lars O.Nilsson, StaffanCharitakis, EmmanouilBång, MagnusNilsson, LennartJanzon, Magnus
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Department of Cardiology in LinköpingDivision of Cardiovascular MedicineFaculty of Medicine and Health SciencesDivision of Community MedicinePrimary Health Care Center VikbolandetHuman-Centered systemsFaculty of Science & EngineeringDepartment of Computer and Information Science
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