CLINICAL DECISION SUPPORT SYSTEMS TO OPTIMIZE ADHERENCE TO ANTICOAGULANT GUIDELINES IN PATIENTS WITH ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Clinical decision support systems to optimize adherence to anticoagulant guidelines in patients with atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials

Clinical decision support systems to optimize adherence to anticoagulant guidelines in patients with atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials

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Abstract Background Clinical decision support systems (CDSS) have been utilized as a low-cost intervention to improve healthcare process measures.Thus, we aim to estimate CDSS efficacy truvisionhealthftp.com to optimize adherence to oral anticoagulant guidelines in eligible patients with atrial fibrillation (AF).Methods A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through August 2023.We used RevMan V.

5.4 to pool dichotomous data using risk ratio (RR) with a 95% confidence interval (CI).PROSPERO ID: CRD42023471806.Results We included nine RCTs with a total of 25,573 patients.

There was no significant difference, with the use of CDSS compared to routine care, in the number of patients prescribed anticoagulants (RR: 1.06, 95% CI [0.98, 1.14], P = 0.

16), the number of patients prescribed antiplatelets (RR: 1.01 with 95% CI [0.97, 1.06], P = 0.

59), grandpas best all-cause mortality (RR: 1.19, 95% CI [0.31, 4.50], P = 0.

80), major bleeding (RR: 0.84, 95% CI [0.21, 3.45], P = 0.

81), and clinically relevant non-major bleeding (RR: 1.05, 95% CI [0.52, 2.16], P = 0.

88).However, CDSS was significantly associated with reduced incidence of myocardial infarction (RR: 0.18, 95% CI [0.06, 0.

54], P = 0.002) and cerebral or systemic embolic event (RR: 0.11, 95% CI [0.01, 0.

83], P = 0.03).Conclusion We report no significant difference with the use of CDSS compared to routine care in anticoagulant or antiplatelet prescription in eligible patients with AF.CDSS was associated with a reduced incidence of myocardial infarction and cerebral or systemic embolic events.

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