Testing a clinical decision support process to lower cardiovascular risk of patients
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INTRODUCTION: More than 30% of adults in the U.S. have a 10% risk or greater of having a heart attack in the next 10 years. The proportion of adults with moderate and high cardiovascular risk (CVR) account for nearly half of the first major cardiovascular (CV) events in the United States. Shared decision support tools may reduce CVR by facilitating and prioritizing provider-patient communication about CV risk.
METHODS: CV Wizard was developed to identify and prioritize uncontrolled CVR factors and offer treatment suggestions. It was integrated into the electronic health record through a web-service and pilot tested with 14 providers at 6 HMPG clinics. CV Wizard was triggered during patient visits for adults age 18-75 with known CV risk factors such as diabetes, heart disease, tobacco use, hypertension, and hyperlipidemia. Staff printed the patient and provider versions of the decision making support. Providers completed a satisfaction survey 6 weeks post-implementation.
RESULTS: Eleven providers completed the survey. Ten said CV Wizard fit well in their workflow. All found the information on the form useful and would recommend it to others. Providers also reported that patients were receptive, all or most of the time, to using the tool. Several (n=3) were encouraged that patients paid more attention to smoking risks.
Conclusion: Preliminary results show that the CV Wizard is promising for engaging patients in decisions to lower CV risk and providers had high satisfaction rates. The patient tool provides an easy to comprehend visual for communicating and prioritizing CV risk reduction, particularly around smoking.