SUPPORT-AF II: Supporting Use of Anticoagulants Through Provider Profiling of Oral Anticoagulant Therapy for Atrial Fibrillation: A Cluster-Randomized Study of Electronic Profiling and Messaging Combined With Academic Detailing for Providers Making Decisions About Anticoagulation in Patients With Atrial Fibrillation.
Administration, Oral
Aged
Ambulatory Care
Anticoagulants
/ administration & dosage
Atrial Fibrillation
/ diagnosis
Attitude of Health Personnel
Clinical Decision-Making
Decision Support Techniques
Drug Utilization
Electronic Health Records
Electronic Mail
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Massachusetts
/ epidemiology
Medical Order Entry Systems
Middle Aged
Patient Selection
Practice Patterns, Physicians'
Reminder Systems
Risk Factors
Stroke
/ diagnosis
Time Factors
Treatment Outcome
anticoagulant
atrial fibrillation
focus groups
knowledge
outpatients
Journal
Circulation. Cardiovascular quality and outcomes
ISSN: 1941-7705
Titre abrégé: Circ Cardiovasc Qual Outcomes
Pays: United States
ID NLM: 101489148
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
entrez:
18
2
2020
pubmed:
18
2
2020
medline:
23
9
2020
Statut:
ppublish
Résumé
Previous provider-directed electronic messaging interventions have not by themselves improved anticoagulation use in patients with atrial fibrillation. Direct engagement with providers using academic detailing coupled with electronic messaging may overcome the limitations of the prior interventions. We randomized outpatient providers affiliated with our health system in a 2.5:1 ratio to our electronic profiling/messaging combined with academic detailing intervention. In the intervention, we emailed providers monthly reports of their anticoagulation percentage relative to peers for atrial fibrillation patients with elevated stroke risk (CHA Our electronic messaging and academic detailing intervention was feasible but did not increase anticoagulation use. Patient-directed interventions or provider interventions targeting patients declining anticoagulation may be necessary to raise the rate of anticoagulation. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT03583008.
Sections du résumé
BACKGROUND
Previous provider-directed electronic messaging interventions have not by themselves improved anticoagulation use in patients with atrial fibrillation. Direct engagement with providers using academic detailing coupled with electronic messaging may overcome the limitations of the prior interventions.
METHODS AND RESULTS
We randomized outpatient providers affiliated with our health system in a 2.5:1 ratio to our electronic profiling/messaging combined with academic detailing intervention. In the intervention, we emailed providers monthly reports of their anticoagulation percentage relative to peers for atrial fibrillation patients with elevated stroke risk (CHA
CONCLUSIONS
Our electronic messaging and academic detailing intervention was feasible but did not increase anticoagulation use. Patient-directed interventions or provider interventions targeting patients declining anticoagulation may be necessary to raise the rate of anticoagulation. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT03583008.
Identifiants
pubmed: 32063041
doi: 10.1161/CIRCOUTCOMES.119.005871
doi:
Substances chimiques
Anticoagulants
0
Banques de données
ClinicalTrials.gov
['NCT03583008', 'NCT03583008']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e005871Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn