Among CVRM patients , the results tended towards a beneficial effect of CDSS , but only LDL-c target attainment in diabetes patients reached statistical significance .
Prompting , integration into the electronical health record , patient empowerment , and medication support were related to more effective CVRM .
Conclusion We did not find a clear clinical benefit from CDSS in cardiovascular risk factor levels and target attainment .
Some features of CDSS seem more promising than others .
Clinical relevance of CDSS in CVRM might additionally be sought in the improvement of shared decision making and patient empowerment
Background Cardiovascular risk management ( CVRM ) is notoriously difficult because of multi-morbidity and the different phenotypes and severities of cardiovascular disease .
Computerized decision support systems ( CDSS ) enable the clinician to integrate the latest scientific evidence and patient information into tailored strategies .
The effect on cardiovascular risk factor management is yet to be confirmed .
Evaluation of Effectiveness and Cost‐Effectiveness of a Clinical Decision Support System in Managing Hypertension in Resource Constrained Primary Health Care Settings: Results From a Cluster Randomized Trial
Background R and omized control trials from the developed world report that clinical decision support systems ( DSS ) could provide an effective means to improve the management of hypertension ( HTN ) . However , evidence from developing countries in this regard is rather limited , and there is a need to assess the impact of a clinical DSS on managing HTN in primary health care center ( PHC ) setting s. Methods and Results We performed a cluster r and omized trial to test the effectiveness and cost‐effectiveness of a clinical DSS among Indian adult hypertensive patients ( between 35 and 64 years of age ) , wherein 16 PHC clusters from a district of Telangana state , India , were r and omized to receive either a DSS or a chart‐based support ( CBS ) system .  Each intervention arm had 8 PHC clusters , with a mean of 102 hypertensive patients per cluster ( n=845 in DSS and 783 in CBS groups ) . Mean change in systolic blood pressure ( SBP ) from baseline to 12 months was the primary endpoint . The mean difference in SBP change from baseline between the DSS and CBS at the 12th month of follow‐up , adjusted for age , sex , height , waist , body mass index , alcohol consumption , vegetable intake , pickle intake , and baseline differences in blood pressure , was −6.59 mm Hg ( 95 % confidence interval : −12.18 to −1.42 ; P=0.021 ) . The cost‐effective ratio for CBS and DSS groups was $ 96.01 and $ 36.57 per mm of SBP reduction , respectively . Conclusion Clinical DSS  are effective and cost‐effective in the management of HTN in re source ‐constrained PHC setting s. Clinical Trial Registration URL : http://www.ctri.nic.in . Unique identifier : CTRI/2012/03/002476
Among CVRM patients , the results tended towards a beneficial effect of CDSS , but only LDL-c target attainment in diabetes patients reached statistical significance .
Prompting , integration into the electronical health record , patient empowerment , and medication support were related to more effective CVRM .
Conclusion We did not find a clear clinical benefit from CDSS in cardiovascular risk factor levels and target attainment .
Some features of CDSS seem more promising than others .
Clinical relevance of CDSS in CVRM might additionally be sought in the improvement of shared decision making and patient empowerment
Background Cardiovascular risk management ( CVRM ) is notoriously difficult because of multi-morbidity and the different phenotypes and severities of cardiovascular disease .
Computerized decision support systems ( CDSS ) enable the clinician to integrate the latest scientific evidence and patient information into tailored strategies .
The effect on cardiovascular risk factor management is yet to be confirmed .