Schizophrenia Clinical Trial
Official title:
Reducing Cardiovascular Risk in Adults With Serious Mental Illness Using an Electronic Medical Record-based Clinical Decision Support
This purpose of this study is to adapt, implement and test the ability of a sophisticated point-of-care electronic health record-based clinical decision support that identifies and prioritizes all available evidence-based treatment options to reduce cardiovascular risk in patients with serious mental illness.
This study adapted a point-of-care electronic health record-based clinical decision support
system (The Cardiovascular Wizard) to help primary care providers identify, provide
appropriate care for, and control cardiovascular risk factors for patients with serious
mental illness (bipolar disorder, schizophrenia, schizo-affective disorder). The
Cardiovascular Wizard is designed to educate primary care providers about the increased risk
of cardiovascular disease and mortality in people with serious mental illness, identify
elevated cardiovascular risk factors in patients with serious mental illness, identify
elevated cardiovascular risk factors in patients with serious mental illness, prioritize
these cardiovascular risk based on how much improvement in cardiovascular risk a patient
would experience if the cardiovascular risk factor was adequately addressed, recommend
specific medications and other interventions to decrease each elevated cardiovascular risk
factor, and provide this information in an easy-to-understand format for both patients with
serious mental illness and their primary care providers.
The Cardiovascular Wizard was printed in intervention clinics and (i) compiled lab data (most
recent glycated hemoglobin, systolic blood pressure and low-density lipoprotein levels), body
mass index, smoking status, and aspirin use, (ii) calculated a modifiable 10 year
cardiovascular risk for stroke or heart attack using the American College of
Cardiology/American Heart Association 10-year atherosclerotic cardiovascular disease risk
equation, (iii) prioritized clinical domains based on the absolute risk reduction for each
component, (iv) compiled information related to liver and renal function, creatinine kinase
level, and previous diagnoses (Congestive Heart Failure, Cardiovascular Disease, Diabetes
Mellitus, and (v) provided recommendations for intensification of therapy for glycated
hemoglobin, systolic blood pressure, and/or low-density lipoproteins if not at goal.
Recommendations were based on evidence-based protocols including Joint National Committee,
American Diabetes Association, and the Institute for Clinical Systems Improvement.
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