The Role of Clinical Decision Support Systems in Preventing Stroke in Primary Care: A Systematic Review

Overview

Journal Perspect Health Inf Manag

Specialties Health Services
Medical Informatics

Date 2023 Jun 9

PMID 37293480

Authors

Salha Fayea Alasiri

Abdel Douiri

Saffanah Altukistani

Talay Porat

Ola Mousa

Affiliations

Soon will be listed here.

Abstract

Computerized clinical decision support systems (CDSS) are increasingly being used to facilitate the role of clinicians in complex decision-making processes. This systematic review evaluates evidence of the available CDSS developed and tested to support the decision-making process in primary healthcare for stroke prevention and barriers to practical implementations in primary care settings. A systematic search of Web of Science, Medline Ovid, Embase Ovid, and Cinahl was done. A total of five studies, experimental and observational, were synthesised in this review. This review found that CDSS facilitate decision-making processes in primary health care settings in stroke prevention options. However, barriers were identified in designing, implementing, and using the CDSS.

Citing Articles

Do clinical decision support tools improve quality of care outcomes in the primary prevention of cardiovascular disease: A systematic review and meta-analysis.

Buzancic I, Koh H, Trin C, Nash C, Hadziabdic M, Belec D Am J Prev Cardiol. 2024; 20:100855.

PMID: 39416379 PMC: 11481602. DOI: 10.1016/j.ajpc.2024.100855.

Perspectives of Decision Support System TeleRehab in the Management of Post-Stroke Telerehabilitation.

Nikolaev V, Nikolaev A Life (Basel). 2024; 14(9).

PMID: 39337844 PMC: 11432844. DOI: 10.3390/life14091059.

References

Shemeikka T, Bastholm-Rahmner P, Elinder C, Veg A, Tornqvist E, Cornelius B . A health record integrated clinical decision support system to support prescriptions of pharmaceutical drugs in patients with reduced renal function: design, development and proof of concept. Int J Med Inform. 2015; 84(6):387-95. DOI: 10.1016/j.ijmedinf.2015.02.005. View

Saini V, Guada L, Yavagal D . Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions. Neurology. 2021; 97(20 Suppl 2):S6-S16. DOI: 10.1212/WNL.0000000000012781. View

Sutton R, Pincock D, Baumgart D, Sadowski D, Fedorak R, Kroeker K . An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ Digit Med. 2020; 3:17. PMC: 7005290. DOI: 10.1038/s41746-020-0221-y. View

Feigin V, Brainin M, Norrving B, Martins S, Sacco R, Hacke W . World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int J Stroke. 2022; 17(1):18-29. DOI: 10.1177/17474930211065917. View

Bonnevie L, Thomsen T, Jorgensen T . The use of computerized decision support systems in preventive cardiology--principal results from the national PRECARD survey in Denmark. Eur J Cardiovasc Prev Rehabil. 2005; 12(1):52-5. View

van der Sijs H, Mulder A, van Gelder T, Aarts J, Berg M, Vulto A . Drug safety alert generation and overriding in a large Dutch university medical centre. Pharmacoepidemiol Drug Saf. 2009; 18(10):941-7. DOI: 10.1002/pds.1800. View

Wang V, Hsieh C, Huang Y, Chen C, Hsieh Y, Chao T . Different utilization of intensive care services (ICSs) for patients dying of hemorrhagic and ischemic stroke, a hospital-based survey. Medicine (Baltimore). 2018; 97(8):e0017. PMC: 5841996. DOI: 10.1097/MD.0000000000010017. View

Mazzaglia G, Piccinni C, Filippi A, Sini G, Lapi F, Sessa E . Effects of a computerized decision support system in improving pharmacological management in high-risk cardiovascular patients: A cluster-randomized open-label controlled trial. Health Informatics J. 2014; 22(2):232-47. DOI: 10.1177/1460458214546773. View

Thomsen T, Davidsen M, Ibsen H, Jorgensen T, Jensen G, Borch-Johnsen K . A new method for CHD prediction and prevention based on regional risk scores and randomized clinical trials; PRECARD and the Copenhagen Risk Score. J Cardiovasc Risk. 2001; 8(5):291-7. DOI: 10.1177/174182670100800508. View

10.

Zikos D, DeLellis N . CDSS-RM: a clinical decision support system reference model. BMC Med Res Methodol. 2018; 18(1):137. PMC: 6240189. DOI: 10.1186/s12874-018-0587-6. View

11.

Bright T, Wong A, Dhurjati R, Bristow E, Bastian L, Coeytaux R . Effect of clinical decision-support systems: a systematic review. Ann Intern Med. 2012; 157(1):29-43. DOI: 10.7326/0003-4819-157-1-201207030-00450. View

12.

Karlsson L, Nilsson S, Bang M, Nilsson L, Charitakis E, Janzon M . A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study). PLoS Med. 2018; 15(3):e1002528. PMC: 5849292. DOI: 10.1371/journal.pmed.1002528. View

13.

Feigin V, Norrving B, Mensah G . Global Burden of Stroke. Circ Res. 2017; 120(3):439-448. DOI: 10.1161/CIRCRESAHA.116.308413. View

14.

Thapa L, Shrestha S, Kandu R, Ghimire M, Ghimire S, Chaudhary N . Prevalence of Stroke and Stroke Risk Factors in a South-Western Community of Nepal. J Stroke Cerebrovasc Dis. 2021; 30(5):105716. DOI: 10.1016/j.jstrokecerebrovasdis.2021.105716. View

15.

Matricardi S, Farello G, Operto F, Coppola G, Verrotti A . What are the challenges with the pharmacological management of epilepsy in patients with Attention Deficit Hyperactivity Disorder (ADHD)?. Expert Opin Pharmacother. 2020; 21(7):737-739. DOI: 10.1080/14656566.2020.1732351. View

16.

Feigin V, Brainin M, Norrving B, Gorelick P, Dichgans M, Wang W . What Is the Best Mix of Population-Wide and High-Risk Targeted Strategies of Primary Stroke and Cardiovascular Disease Prevention?. J Am Heart Assoc. 2020; 9(3):e014494. PMC: 7033901. DOI: 10.1161/JAHA.119.014494. View

17.

Arts D, Abu-Hanna A, Medlock S, van Weert H . Effectiveness and usage of a decision support system to improve stroke prevention in general practice: A cluster randomized controlled trial. PLoS One. 2017; 12(2):e0170974. PMC: 5330455. DOI: 10.1371/journal.pone.0170974. View

18.

Wang Y, Bajorek B . Clinical pre-test of a computerised antithrombotic risk assessment tool for stroke prevention in atrial fibrillation patients: giving consideration to NOACs. J Eval Clin Pract. 2016; 22(6):892-898. DOI: 10.1111/jep.12554. View

19.

Wang Y, Bajorek B . Selecting antithrombotic therapy for stroke prevention in atrial fibrillation: Health professionals' feedback on a decision support tool. Health Informatics J. 2018; 24(3):309-322. DOI: 10.1177/1460458216675498. View

20.

Njie G, Proia K, Thota A, Finnie R, Hopkins D, Banks S . Clinical Decision Support Systems and Prevention: A Community Guide Cardiovascular Disease Systematic Review. Am J Prev Med. 2015; 49(5):784-795. PMC: 5074080. DOI: 10.1016/j.amepre.2015.04.006. View