Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial

• HIT Description: Electronic health record and computerized decision support. More info...
  
• Purpose of Study: Examine the effect of a computer based clinical decision support system and a risk chart in hypertensive patients.
  
• Years of study: 1996-1998
  
• Study Design: RCT
  
• Outcomes: Impact on health care effectivness/quality
  

• Settings: Six hundred fourteen patients with high blood pressure from 27 general practices in Avon, UK participated in the study.
• Intervention: The interventions studied were: 1) computer based clinical decision support system plus cardiovascular risk chart; 2) cardiovascular risk chart alone; 3) usual care.
• Evaluation Method: Measures of absolute cardiovascular risk, blood pressure, and prescriptions of cardiovascular drugs.
• Description: The computing systems used in the study were: EMIS and AAH Meditel.
• Quality of Care and Patient Safety Outcome: Patients in the computer based clinical decision support system and chart only groups were no more likely to have cardiovascular risk reduced to below 10% than patients receiving usual care. Patients in the computer based clinical decision support group were more likely to have a cardiovascular risk >/=10% than chart only patients, odds ratio 2.3 (95% confidence interval 1.1 to 4.8). The chart only group had significantly lower systolic blood pressure compared with the usual care group (difference in means -4.6 mm Hg (95% confidence interval -8.4 to -0.8)). Reduction of diastolic blood pressure did not differ between the three groups. The chart only group was twice as likely to be prescribed two classes of cardiovascular drugs and over three times as likely to be prescribed three or more classes of drugs compared with the other groups.