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Evaluation of computerized decision support for oral anticoagulation management based in primary care

Authors

Fitzmaurice DA, Hobbs FD, Murray ET, Bradley CP, Holder R

Journal

Br J Gen Pract

Publication Date

1996 Sep

Volume

Issue

410

Pages

533-5

HIT Description: Computerized-based decision support system More info...
Purpose of Study: To test the effectiveness of using a computerized decision-support system for oral anticoagulation monitoring and management.
Years of study: 1993
Study Design: Pre-post (practice A) and randomized-control (practice B)
Outcomes: Level of INR control, adverse events, patient satisfaction, overall costs.

Summary:

Settings: Two inner city primary care practices (Birminghan, U.K.)
Intervention: Warfarin dosing assisted by computerized decision-support system.
Evaluation Method: Self-reporting of cumulative INR data, morbidity data, and patient satisfaction from mailed survey.
HIT System: Anticoagulation management decision-support software (DOS-based) on stand-alone dedicated laptop computers.
Quality of Care and Patient Safety Outcome: Improvement in INR control from 23% (pre) to 89% (post) in group A (p0.001), and insignificant change from 43% (control) to 73% (intervention) in group B (p0.25).
Changes in healthcare costs: Savings estimated at £436 in the first year of use, and £2604 for each subsequent year with the computerized system.
Time needed to accrue benefit: within one year (per estimate above)�

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