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 .
Multifaceted support to improve clinical decision making in diabetes care: a randomized controlled trial in general practice.
AIMS To evaluate the effectiveness of a multifaceted intervention to improve the clinical decision making of general practitioners ( GPs ) for patients with diabetes . To identify practice characteristics which predict success . METHODS Cluster r and omized controlled trial with 124 practice s and 185 GPs in The Netherl and s. The intervention group received feedback reports and support from a facilitator ; the control group received no special attention . Outcome measures were the  compliance rates with evidence -based recommendations pertaining to discussion of body weight control , discussion of problems with medication , blood pressure measurement , foot examination , eye examination , initiating anti-diabetic medication or increasing the dosage in cases of uncontrolled blood glucose , and scheduling a follow-up appointment .  RESULTS The GPs reported on their clinical decision making in 1410 consultations with Type 2 diabetic patients at baseline and 1449 consultations after the intervention period . The intervention result ed in statistically significant improvement for two of the seven outcome measures : foot examination ( odds ratio 1.68 ; 95 % confidence interval 1.19 - 2.39 ) and eye examination ( 1.52 ; 1.07 - 2.16 ) . Discussion of problems with medication showed a near significant trend towards increased benefit for the intervention group ( 1.52 ; 0.99 - 2.32 ) . Practice characteristics were not found to be related to the success of the intervention . CONCLUSIONS Feedback reports with support from facilitators appear to increase rates of foot examination and eye examination in general practice . Alternative interventions should be explored to improve the pursuit of metabolic control by GPs
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 .