A Cluster Randomized Controlled Trial to assess the effectiveness of an electronic clinical decision support(e-CDSS)system in enabling translation of clinical knowledge into practice among trained physicians

Title: A Cluster Randomized Controlled Trial to Assess the effectiveness of an electronic clinical decision support system (e-CDSS) in enabling translation of clinical knowledge into practice among trained physicians

Objectives: Primary: To evaluate the impact of an e-CDSS in the practical application of new knowledge from a large scale continuing medical education program.

Secondary: To identify enablers as well as barriers faced by the healthcare provider in implementing changes to clinical practice recommended by the e-CDSS and the continuing medical education program.

Study Setting: The mPower is a knowledge-based Clinical Decision Support System designed to support healthcare providers in delivering evidence-based care to the patients. Certificate Course in Management of Hypertension (CCMH) is a unique initiative designed to enhance knowledge, skills and core competencies of Physicians in the management of hypertension.The fourth cycle of the CCMH program will launch in the month of January 2021 and aims to train approximately 165 physicians. A cluster randomized controlled trial will be done to assess the effectiveness of the e-CDSS in improving translation of knowledge imparted through the continuing medical education program. Anonymized electronic patient records will be analyzed to assess change in prescription patterns.

Study Outcomes:

1.       Initiation of pharmacotherapy in newly diagnosed hypertensives.

2.       Intensification of pharmacotherapy in known hypertensive with uncontrolled blood pressure

3.       Taking three blood pressure measurements in patients of unknown hypertension status or with first BP reading of systolic BP above 140 mmHg and/or diastolic BP above 90mmHg.

Inclusion criteria: All participants that enroll for CCMH Cycle 4 and give consent for the study will be enrolled for baseline evaluation.

Exclusion criteria: Withdrawal from the study after baseline evaluation; Failure to complete CCMH course [ineligibility for final examination (attended < the minimum 7/8 course sessions; did not submit two mandated interim assignments) and failure to secure minimum 50% marks in final examination].

Plan of Data Analysis:

Data in the control arm will be collected using REDCap. Data in the intervention arm will be collected on the mPower eCDSS. Data will be analyzed using SPSS Version 26. Appropriate themes and domains will be identified, and will be described accordingly.