Effectiveness of Clinical Decision Support Based Intervention in the Improvement of Care for Adult Sickle Cell Disease Patients in Primary Care.
Effectiveness of Clinical Decision Support Based Intervention in the Improvement of Care for Adult Sickle Cell Disease Patients in Primary Care.
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DOI：
10.3122/jabfm.2018.05.180106
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Coates TD
中科院分区：
文献类型：
--
作者：
Mainous AG 3rd;Carek PJ;Lynch K;Tanner RJ;Hulihan MM;Baskin J;Coates TD
虽然大多数罕见病患者如镰状细胞病（SCD）在初级保健环境中接受治疗，但初级保健医生可能会发现，与罕见和复杂疾病治疗相关的药物改进和并发症是具有挑战性的。本研究的目的是评价基于临床决策支持（CDS）的干预系统对成人SCD患者输血铁过载的有效性，以改善初级保健管理。评价了一种基于电子病历的临床决策支持系统，用于初级保健中SCD患者的潜在输血铁过载。干预在3个家庭医学诊所实施，对照组为3个普通内科诊所。在干预前6个月和干预后6个月收集数据。家庭医学组47例，普通内科组24例。对照组的管理没有变化，而干预组的初级保健管理从0%提高到44%（P <0.001）。CDS工具可以改善初级保健中SCD患者的管理。（J Am Board Fam Med 2018;31：812-816.）
Although most patients with rare diseases like sickle cell disease (SCD) are treated in the primary care setting, primary care physicians may find it challenging to keep abreast of medication improvements and complications associated with treatment for rare and complex diseases. The purpose of this study was to evaluate the effectiveness of a clinical decision support (CDS)-based intervention system for transfusional iron overload in adults with SCD to improve management in primary care. An electronic medical record based clinical decision support system for potential transfusional iron overload in SCD patients in primary care was evaluated. The intervention was implemented in 3 family medicine clinics with a control group of 3 general internal medicine clinics. Data were collected in the 6 months before the intervention and 6 months after the intervention. There were 47 patients in the family medicine group and 24 in the general internal medicine group. There was no management change in the control group while the intervention group improved primary care management from 0% to 44% (P < .001). A CDS tool can improve management of SCD patients in primary care. (J Am Board Fam Med 2018;31:812–816.)
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