An Implementation Model for Clinical Decision Support for Heart Failure Prescribing

Not Applicable

Completed

• Conditions: Decision Support Systems, Clinical; Heart Failure
• Interventions: Other: Decision Support Systems, Clinical

• Registration Number: NCT04028557
• Lead Sponsor: University of Colorado, Denver

Brief Summary

The objective of this proposal is to compare clinical outcomes, implementation metrics (i.e., patient reach and clinician adoption), and clinician preferences of two designs (customized vs. commercial) of a clinical decision support (CDS). Beta blocker prescribing for patients with heart failure will be used as a test case. The best practices in CDS design, including the user-centered design will be incorporated into the customized CDS and compared to a commercially-available CDS in the electronic health record using a cluster randomized trial.

Detailed Description

Not available

Study Timeline

• Study Start: 2019-06-24
• Study First Submitted: 2019-07-08
• Study First Submitted QC: 2019-07-18
• Study First Posted: 2019-07-22
• Primary Completion: 2019-09-23
• Study Completion: 2019-09-23
• Status Verified: 2022-05
• Last Update Submitted: 2022-05-04
• Last Update Posted: 2022-05-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 118

Inclusion Criteria

• Prescribing primary care clinicians at University of Colorado Health (UCHealth) who provide care for patients with heart failure and reduced ejection fraction

Exclusion Criteria

• None

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Commercial CDS	Decision Support Systems, Clinical	The commercial CDS is available to all institutions using the Epic electronic health record vendor, but violates some CDS design best practices, notably not being tailored to the end users of a given health system. The recommendation will be to initiate an evidence-based beta blocker for heart failure.
Customized CDS	Decision Support Systems, Clinical	The customized CDS will be designed and implemented with comprehensive application of known best practice principles in CDS design. The recommendation will be to initiate an evidence-based beta blocker for heart failure.

Primary Outcome Measures

Name	Time	Method
Change in prescription of Beta blocker (BB)	6 months post CDS implementation	Number of prescriptions of an evidence based BB during a primary care office visit.

Secondary Outcome Measures

Name	Time	Method
Factors Influencing Clinician Adoption of the CDS per Qualitative Interviews	6 months post CDS implementation	Clinician-reported factors that influence adoption of the CDS.
Clinician Adoption	6 months post CDS implementation	The proportion of CDS who were not outright dismissed by the clinician.
Patient Reach	6 months post CDS implementation	The proportion of unique patients with heart failure who were seen by primary care and not taking an evidence based BB who the CDS fired for.

Trial Locations

Locations (1)

University of Colorado Health; 🇺🇸 Aurora, Colorado, United States